Pharmacy Technician Exam Review

Conversions

• Pounds to Kilograms: Divide pounds by 2.2 to get kilograms. (\text{kg} = \frac{\text{lbs}}{2.2})
• Kilograms to Pounds: Multiply kilograms by 2.2 to get pounds. (\text{lbs} = \text{kg} \times 2.2)
• Inches to Centimeters: 1 inch is equal to 2.54 cm. (1 \text{ inch} = 2.54 \text{ cm})
• Feet to Meters: Conversion between feet and meters.
• Milligrams to Grains: 1 grain is approximately 65 mg. (1 \text{ grain} = 65 \text{ mg})
• Milliliters to Pint: 1 pint is approximately 473 mL.
• Milliliters per Teaspoonful: 1 teaspoonful is equal to 5 mL. (1 \text{ tsp} = 5 \text{ mL})
• Milliliters per Tablespoonful: 1 tablespoonful is equal to 15 mL. (1 \text{ tbsp} = 15 \text{ mL})
• Ounces to Pound: 16 ounces is equal to 1 pound. (16 \text{ oz} = 1 \text{ lb})
• Pounds to Grams: 1 pound is approximately 454 grams. (1 \text{ lb} = 453.6 \text{ g})
• Ounce to Milliliters: 1 fluid ounce is approximately 30 mL.

Abbreviations

• Bid: Twice a day
• Tid: Three times a day (Outlawed)
• Qid: Four times a day (Outlawed)
• QD: Once a day
• QS: Sufficient quantity
• qod: Once every other day
• OU: Both eyes
• OD: Right eye
• OS: Left eye
• AU: Both ears
• AD: Right ear
• AS: Left ear
• Hs: At bedtime
• ac: Before meals
• pc: After meals

JTC Abbreviation Bans

• Sq or SC: Write either subcutaneous or subcuaneously.
• U: Can be confused with unit or a zero.
• MgSO4: Similar to MSO4.
• MSO4: Similar to MgSO4.

Drug Endings

• -triptan: Serotonin receptor agonists, used for treating migraines.
• -Mycin: Macrolide antibiotics used to treat bacterial infections.
• -tidine: H2 receptor antagonists, used for treating GERD.
• -Oprazole: Proton pump inhibitors (PPIs).
• -Statin: Lipid-lowering drugs.
• -Terol: Beta-adrenergic agonists.
• -pril: ACE inhibitors.
• -sartan: Angiotensin II receptor blockers (ARBs).
• -dipine: Calcium channel blockers.
• -vir: Antivirals.

Drugs and Diseases

• Main cause of constipation: Low fiber intake.
• Common anticoagulants: Warfarin, Xaban, Arin.
• Special dosing considerations: Children, elderly, hospice patients.
• Main site of drug absorption: Small intestine due to large surface area.
• Most dangerous allergic reaction: Anaphylaxis.
• Most common psych disorder: Depression.
• Requirements for bioequivalence: Same active ingredients, dosage, ROA(Route of Administration), same dosage form.
• GERD treatment drugs: Proton pump inhibitors (PPIs).
• Common cause of seizures: Overactivity in the brain, fevers.
• Physical changes in elderly affecting dosing: Weight, kidney disease, liver disease, malabsorption.
• Complications of high cholesterol: Stroke, heart failure, blood clots (arteriosclerosis, atherosclerosis).
• Treatment for infectious diarrhea in children: Alinia.
• Drug to make RBCs: iron dextran, Erythropoietin, Epogen
• Treatment for diabetic foot ulcers: Regranex (topical gel).
• Diuretics and indications:
  • HCTZ (Hydrochlorothiazide): thiazide diuretic for hypertension (HTN).
  • Furosemide (Lasix): loop diuretic for congestive heart failure (CHF).
  • Aldactone: potassium-sparing diuretic
• Drugs causing tardive dyskinesia
• Drug effect causing noncompliance
• OTC cough and cold classifications:
  • Antitussive: Cough suppressants
  • Decongestant: Sudafed
  • Expectorant: Mucinex
  • Antipyretic: Tylenol reduces
  • Analgesic: Advil reduces pain
  • Antihistamine: Benadryl, Zyrtec - Dries up runny nose
• Monobactam antibiotic: Aztreonam
• Vaccines:
  • Herpes simplex: No
  • Herpes zoster: Shingrix (Yes)
  • Hepatitis A: Havrix (Yes)
  • Hepatitis B: Engerix (Yes)
  • Hepatitis C: No
  • Measles: MMR vaccine (Yes)
  • HIV: No
• OTC nicotine products: Nicogum, patches, lozenges.
• Chronic viral infections: Flu, hepatitis.

Indications for Medications

• Antiarrhythmics: Control cardiac rhythm.
• Phenytoin: For seizures (acute and chronic).
• Interferon: For cancers, multiple sclerosis.
• Sumatriptan: For migraine.
• Pancrealipase (Creon-10): For pancreatic enzyme insufficiency.

Mechanism of Action

• Precose (Acarbose): Anti-diabetic, inhibits absorption of glucose, taken with the first bite of food.
• Allopurinol: Xanthine oxidase inhibitor, prevents gout by reducing uric acid production.
• Metoclopramide: Anti-nausea.

Interpreting Prescriptions

• Number of tablets needed for the prescription (Rx).
• Number of mLs needed for Rx.
• Correctly type a label.
• Correctly interpret the sig of the Rx.

Dosage Forms

• Immediate vs. Sustained Release: Understand when to use each and how to identify them on labels.
• Therapeutic Equivalence: Same dosage drug, same active ingredient, same ROA, same dosage form.
• Generic vs. Brand Effectiveness: Generic drugs should have same effectiveeness, brand drugs more expensive.

Controlled Substances

• CI: Heroin, meth, marijuana, crack, LSD, ecstasy (highest abuse potential).
• CII: Oxycodone, cocaine, morphine, fentanyl (liquid or patch).
• CIII: Paregoric, testosterone, Tylenol with codeine
• CIV: Lorazepam, sleep medications.
• CV: cough preperations, pregabalin
• Inventory frequency: Every 2 years.
• Highest abuse potential: CI.
• Lowest abuse potential: highest.

USP Standards

• USP 800: Hazardous drugs (HDs).
  • Identified by:
    • Carcinogenicity, teratogenicity, or developmental toxicity; Genetic problems
    • Reproductive toxicity in humans.
    • Organ toxicity at low doses in humans or animals.
    • Genotoxicity or new drugs mimicking existing HDs.
  • Areas of exposure and precautions.
• USP 795: Non-sterile compounding.
  • Beyond-use dating (BUD) determination.
  • Pharmacist checks as the last step.
• USP 797: Sterile compounding.
  • Old: components drive the BUD, complexitiy of process, single or many patients, Sterile or non-sterile.
  • New: facility design drives BUD.
    • Cleanroom suite
    • Segregated compounding area

Calculations

• Alligation problems.
• AWP Reimbursement: AWP - \text{discount} + \text{dispensing fee} = \text{reimbursement}
• mEq needed for IVs. example 18 \text{mEq}, 4.5 \text{mg/ml} = 4 \text{ml}
• Total grams per Rx calculation.
• mg/dose or mg/day calculations.
• Jars needed for compounding calculation.
• Inventory days' supply.
• Units for metric and US systems.
• Solid units (metric and US).
• Liquid units (metric and US).
• Errors: Decimal point misinterpretation.
• Trailing zeros.
• % discount calculation.
• Grains calculation.
• Tablets per day problem.
• Inhaler days' supply problem.
• Pints to dispense calculation.
• Conversions: lbs to kg.
  • \frac{175 \text{lbs}}{2.2} = 80 \text{kg}

Agency and Publication Responsibilities

• DEA: Controlled substances.
• FDA: New drugs, herbals, and dietary supplements, Orange book publication.
• CDC: Handwashing techniques and touch contamination.
• Orange Book: Approved drugs and therapeutic equivalence, FDA published.
• MedWatch: Report medication errors and ADRs.
• NIOSH: Hazardous drug handling conditions.

Aseptic Technique

Purpose of Aseptic TechniquePrevent contamination of sterile products.
*Minimize touch contamination
*Proper hand washing techniques
*Clean room parts and definitions: Ante room, buffer zone
*Risk levels of Aseptic compounding
*Parts of the needle and gauge numbers
*Material for CSP containers: plastic

Community Pharmacy

• Automated time systems.
• Advantages of belonging to professional organizations.
• Script validity: Controlled substances last 6 months 120 days, non-controlled substances last 1 year, can't track down.
• Acceptable error rate: 0
• Refill restriction, and first step in verification of patient (name, DOB, address)
• Safety cap law, and the verification needed to ensure a patient can get their meds (name, addres, DOB, phone #)

Technician Responsibilities for Prescription

• Last step: Get the pharmacist to check it.
• Drug recalls: NDC, lot number, expiration date, name.
• Technician restrictions: No consulting, recommending, transferring Rx, or calling in new Rxs.
  *Communities must check for: inventory, stocking, cashiering, vaccines, insulin
  *

Auxiliary labels - Types and reasons

Pregnancy categories (a,b,c,d,x)

Term definitions (Solute, solution, dilutent, etc)