ExCPT Pharmacy Technician (CPhT) Study Notes

I. Pharmacy Law and Regulations

A. Federal Laws

  • Food, Drug, and Cosmetic Act (FDCA) of 1938: Established the FDA; drugs must be safe and labeled accurately.

  • Controlled Substances Act (CSA) of 1970: Created DEA schedules I–V for drugs with abuse potential.

  • Drug Enforcement Administration (DEA): Regulates controlled substances and issues DEA numbers.

  • Poison Prevention Packaging Act (PPPA) of 1970: Child-resistant packaging required for most prescription meds.

  • Health Insurance Portability and Accountability Act (HIPAA) of 1996: Patient privacy and confidentiality.

  • Omnibus Budget Reconciliation Act (OBRA) of 1990: Requires counseling for Medicaid patients.

  • Combat Methamphetamine Epidemic Act of 2005: Limits sales of pseudoephedrine and logbook requirements.

B. DEA Schedules

  • Schedule I (C-I): No accepted medical use (heroin, LSD).

  • Schedule II (C-II): High abuse, no refills; morphine, oxycodone, methylphenidate.

  • Schedule III (C-III): Moderate abuse; Tylenol with codeine.

  • Schedule IV (C-IV): Low abuse; alprazolam, diazepam.

  • Schedule V (C-V): Lowest abuse; cough preps with codeine.

C. Prescription Requirements

  • Patient name, address, date

  • Drug name, strength, dosage form, and quantity

  • Directions for use

  • Prescriber’s name, signature, DEA # (if controlled)

D. Key Pharmacy Laws

  • State vs. Federal: Always follow the stricter law

  • Refill rules: C-II = no refills; C-III to V = up to 5 refills in 6 months

  • Recordkeeping: 2 years minimum (often 3–5 by state)

II. Pharmacy Calculations

  • Conversions: 1 tsp = 5 mL, 1 tbsp = 15 mL, 1 oz = 30 mL, 1 kg = 2.2 lbs

  • Allegation: Used for compounding

  • Days’ supply: (Quantity dispensed) ÷ (Daily dose)

  • IV flow rates: (Volume (mL) × Drop factor (gtt/mL)) ÷ Time (min)

III. Pharmacology: Top 200 Drugs

A. Common Drug Classes & Examples

Analgesics

  • Opioids: oxycodone (OxyContin), hydrocodone/acetaminophen (Norco), morphine

  • NSAIDs: ibuprofen (Advil), naproxen (Aleve)

Antibiotics

  • amoxicillin (Amoxil)

  • azithromycin (Zithromax)

  • ciprofloxacin (Cipro)

Antihypertensives

  • lisinopril (Prinivil, Zestril)

  • amlodipine (Norvasc)

  • metoprolol (Lopressor)

  • losartan (Cozaar)

Antidiabetics

  • metformin (Glucophage)

  • insulin glargine (Lantus)

Antidepressants

  • sertraline (Zoloft)

  • fluoxetine (Prozac)

  • escitalopram (Lexapro)

Statins (Cholesterol)

  • atorvastatin (Lipitor)

  • simvastatin (Zocor)

Anticonvulsants

  • gabapentin (Neurontin)

  • levetiracetam (Keppra)

Proton Pump Inhibitors (PPIs)

  • omeprazole (Prilosec)

  • pantoprazole (Protonix)

Asthma/COPD

  • albuterol (ProAir, Ventolin)

  • fluticasone/salmeterol (Advair)

Anticoagulants

  • warfarin (Coumadin)

  • apixaban (Eliquis)

IV. Pharmacy Operations

  • Prescription processing steps

  • Labeling requirements

  • Inventory control

  • Handling recalls

  • Medication storage (fridge, room temp, light protection)

  • Patient safety: tall man lettering, LASA (Look-Alike, Sound-Alike) drugs

V. Medication Safety

  • Error prevention: Barcoding, double checks

  • Reporting errors: MedWatch, ISMP

  • High-alert meds: Insulin, anticoagulants, opioids

VI. Compounding and Sterile Preparations

  • Non-sterile compounding: Suspensions, ointments

  • Sterile compounding: IV admixtures, USP <797> guidelines

  • Aseptic technique: Hand washing, hood cleaning

VII. Insurance and Billing

  • Common terms: Copay, coinsurance, deductible, prior authorization

  • Third-party processing: BIN, PCN, Group #

  • Medicare/Medicaid: Part D = Prescription benefits

VIII. Common Pharmacy Abbreviations

  • Sig codes: po (by mouth), qd (once daily), bid (twice daily), tid (three times daily), qid (four times daily), prn (as needed), ac (before meals), pc (after meals), hs (at bedtime).

IX. Study Tips

  • Memorize Top 200 drugs: Brand/generic, class, use

  • Know DEA schedules and key laws

  • Practice calculations regularly

  • Review common side effects and drug interactions

  • Use flashcards and quizzes for repetition