Comprehensive Pharmacy Technician Exam Notes (English)
I. Content Outline (Pharmacy Technician Certification Examination)
I. Assisting the Pharmacist in Serving Patients (66% of exam)
Involves activities related to traditional prescription dispensing and medication distribution.
Tasks include:
Receive prescription/medication order from patient, patient’s representative, prescriber, or other health professionals.
At pharmacist’s direction, obtain information from patient or representative: diagnosis, desired therapeutic outcome, medication use, allergies, adverse reactions, medical history, psychosocial history, visual impairment, physical disability, reimbursement mechanisms.
Assess prescription/medication order for completeness, correctness, authenticity, legality.
Obtain important information from prescriber/healthcare professionals as directed by the pharmacist.
Update medical record/patient profile with medication history, allergies, duplication, and/or drug–disease, drug–drug, drug–laboratory interactions.
Process the prescription/medication order.
Storing and delivering medication to patient/patient’s representative.
Determine charges and obtain compensation for services.
Provide supplemental information as indicated (e.g., patient package inserts, computer information, videos).
II. Medication Distribution and Inventory Control Systems (22% of exam)
Encompasses purchasing, inventory control, and preparation/distribution of medications per policies.
Key duties:
Place orders for pharmaceuticals, durable medical equipment, devices, and supplies.
Receive goods and verify specifications on original purchase orders.
Store pharmaceuticals and supplies under proper storage conditions.
Remove expired/discontinued/slow-moving items and document actions.
Recalls and document actions taken.
Identify supplies to be ordered (e.g., “want book”).
Communicate changes in product availability (formulary changes, recalls).
Maintain policies/procedures to deter theft and/or drug diversion.
Maintain records of controlled substances received, stored, and removed.
Maintain recordkeeping systems for repackaging, recalls, and returns of supplies.
Compound medications in anticipation of prescriptions/medication orders (bulk compounding).
Prepackage finished dosage forms for dispensing.
Collect and analyze data on the quality of pharmacy products and services.
III. Operations (12% of exam)
Administrative processes for the pharmacy practice.
Typical duties:
Coordinate communications across practice center/service area.
Participate in meetings to obtain feedback on performance.
Monitor compliance with federal, state, and local laws/regulations and standards.
Implement and monitor policies for sanitation, hazardous waste handling, infection control.
Sanitation, maintenance, and calibration of equipment; routine records.
Maintain manual or computer-based information systems.
II. Are You Ready? Checklist (Study Prep)
Complete registration with the PTCB and pick a test date.
Purchase study materials: Study Manual, Math Workbook, Advanced Math Problems, Practice Exams.
Review differences between Prescription vs Medication Order; importance of patient profiles; referral to pharmacist when needed.
Learn Latin abbreviations; Absorption/Distribution/Metabolism/Elimination definitions; Dosage forms; NDCs; Expiration dates; Unit doses; Conversions; fractions/decimals/Roman numerals; Flow rates; Weights and balances; Mortars and definitions (Levigation, Trituration, Punch Method).
Study therapeutic areas: Antibiotics, Cardiovasculars, GI Meds, Respiratory Meds, Diabetes, Analgesics, Blood Disorders, Psychotherapeutics, Hormones, HIV/AIDS, Topicals.
Aseptic technique dos/don’ts; Equipment operation basics; Horizontal vs. Vertical flow hoods; Filtration/airflow; Syringes/Needles anatomy; Vials vs ampoules; IVs.
Review laws and regulatory topics: FDA, Durham-Humphrey, Kefauver-Harris, Poison Prevention Packaging Act, Occupational Safety Act, OBRA, CSA, DEA forms, Form 222, And more.
Prepare a checklist with syllabus references; bring pencils and a non-programmable calculator; sleep well before exam.
III. Prescription Basics and Differences
What is a prescription?
An order for a medication issued by a licensed medical practitioner (e.g., physician, dentist, veterinarian, podiatrist, physician assistant, nurse practitioner).
A prescription is required when medicine requires medical supervision; drug may be unsafe without supervision.
Manufacturer labeling typically states: “Caution: Federal Law Prohibits dispensing without a prescription.”
Forms of a prescription:
Written form from the office.
Phone-in prescriptions (RPhs and Interns may take; CIIs not permitted by phone for certain cases).
Faxed prescriptions (with exceptions for CIIs).
Electronic prescriptions (e-prescriptions; CIIs usually not allowed to be transmitted electronically in some jurisdictions).
Prescription vs medication order:
A prescription is an order given to the patient to fill.
A medication order is used in hospital/institutional settings and kept on one sheet for the entire staff; includes diagnoses, diet, allergies, etc.
Refill requests:
Technicians may initiate refill requests and must provide to the doctor’s office: pharmacy name/phone, patient name/DOB, drug name/strength/quantity, directions, date of last refill.
IV. Elements of a Prescription and Labeling
Elements of a prescription (outpatient and inpatient)
Patient name, route of administration, drug name (generic or brand), dosage form (if multiple), dose, strength (if multiple), quantity and frequency, prescriber’s name, and signature, date written, and refill information.
For inpatient/hospital orders, additional elements: rate/time of administration, allergy information, account/admission/room information, diagnosis, diet, indication for use.
Prescription labeling (FDCA requirements and state refinements)
Required by FDA: name and address of pharmacy, Rx number, date, prescriber name, patient name, directions for use, dispensing pharmacist initials, pharmacy phone, drug name/strength/form/quantity, expiration date, manufacturer, and lot or control number, plus refill info.
State requirements may add: patient address, pharmacist initials/name, pharmacy phone, manufacturer, lot, etc.
Special instruction: For controlled substances, the label must include the warning: “Caution: Federal Law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.” Do not cover with an auxiliary label.
Elements of a prescription label (overview): same as above; ensure completeness and compliance.
V. Patient Profiles and When to Refer
A patient profile includes:
Patient name, ID, DOB/age, sex, contact information, diagnoses, health conditions, practitioner names, medication allergies, third-party payer info, medication history (current/old/OTC), special considerations (foreign language), clinical comments (therapeutic monitoring, counseling notes), and desired therapeutic outcome.
Active medications should be listed first; OTCs should be included for interaction monitoring.
Referring to a pharmacist:
Technicians should not interpret patient questions requiring professional judgment.
When drug interactions, disease-state interactions, or drug–food interactions are suspected, refer to the pharmacist.
Three main reasons to refer to a pharmacist include Drug–Drug interactions, Drug–Disease interactions, Drug–Food interactions; and Need for physician referral.
VI. Common Latin Abbreviations (to memorize)
a: ante
aa: of each
ac: before meals
ad lib: as much as desired
ad: right ear; as: left ear
am: before noon; p.m.: after noon
bid: twice daily; tid: three times daily; qd: every day; qod: every other day; qh: every hour; q4h: every 4 hours
po: by mouth; pr: rectally; prn: as needed; stat: now
sig: directions; sl: sublingual; os: left eye; od: right eye; au: both ears; ss: 1/2
Ut dict, ud, utd: as directed
dtd: give such doses; gtt/gtts: drops; h: hour; hs: at bedtime; measurment terms, etc.
VII. Fractions, Decimals, Roman Numerals, and Conversions
Reducing fractions to lowest terms
Example: ( \frac{15}{24} ) ÷ 3 = ( \frac{5}{8} )
Converting mixed fractions to improper fractions
Example: (2\frac{3}{5} = \frac{13}{5})
Decimal/ fraction conversions
1/4 = 0.25; 13/5 = 2.6
Converting decimals to fractions and vice versa
Tenths, hundredths, thousandths, etc.
Roman numerals basics (and subtraction rules): I=1, V=5, X=10, L=50, C=100, D=500, M=1000
Subtractive form examples: CM=900, XL=40, IX=9, etc.
Rules: never subtract more than one numeral; repeats up to three times; long numerals read left-to-right with addition/subtraction as appropriate.
Practice problems and conversions (from pages 12–26): see section on practice problems and conversions for example problems and answers.
Key conversions to memorize (Household, Metric, Apothecary):
Length/Volume/Weight:
(1\text{ L} = 1000\,\text{mL})
(1\text{ g} = 1000\,\text{mg})
(1\text{ mg} = 1000\,\mu\text{g})
(1\text{ kg} = 2.2\text{ lb})
(1\text{ oz} = 30\text{ g}) (approx alternative in some contexts)
Apothecary vs. Household: note differences and use the provided memory aids; examples include 1 pint = 480 mL (household) vs. 473 mL (apothecary), etc.
Common household conversions: 1 tsp = 5 mL; 3 tsp = 1 Tbsp; 1 Tbsp = 15 mL; 1 cup = 240 mL; 1 pint = 480 mL; 1 gallon = 3785 mL; 2.2 lb = 1 kg.
Metric conversions: place decimal and use loops to move the decimal; cross-multiplication is a key approach.
VIII. Alligation (Tic-Tac-Toe) Method
Purpose: to mix two strengths to obtain a desired strength, then compute amounts for any total volume.
Steps:
1) Place the highest strength in the upper-left, the lowest strength in the lower-left, and the desired strength in the middle.
2) Subtract diagonally to produce two numerators (no negatives).
3) Denominator is the sum of the two numerators.
4) Numerator/Denominator gives the proportion for each ingredient (as a fraction, then decimal).
5) Multiply those decimals by the total amount to obtain the amounts needed of each ingredient.Example summary (from notes): mixing 70% and 30% to prepare 450 mL of 70/30 mix to achieve a certain target; the tic-tac-toe approach yields the fractions that sum to 1 and can be scaled to 450 mL.
Important check: the two calculated amounts should sum to the total and the fractions form a valid ratio.
IX. Flow Rates (gtts/min) and IV Calculations
Key concept: flow rate problems often require cross-multiplication and unit analysis.
Core formulas:
Drops per minute (gtts/min):
where V = total volume (mL), D = drops per mL (calibration), t = time in hours.If given gtt/min and drops per mL, compute mL/hr:
Example workflow (from notes): set up a tic-tac-toe style grid with bag size, hours to infuse, calibration, and then compute across to get gtts/min. When asked for mL/hr, convert accordingly.
Practice problems emphasize consistent unit handling and cross-multiplication.
X. Repackaging, Expiration, and Unit Dose Rules
Repackaging (unit-dose) rules:
Expiration dating on repackaged unit doses is 50% of the expiration date on the stock bottle, with a maximum of 1 year.
Unit dose labeling requirements:
Drug name, strength, dosage form
Lot number (for recalls)
Expiration date
Directions
Auxiliary labels
Storage and cautions
Manufacturer
Repackaging date
Purpose and advantages of unit-dose packaging include reduced medication errors, better control, minimized drug waste, shorter preparation time, and more accurate patient billing.
XI. Pharmacy Measurements, Apothecary vs Household, and Story Problems
The material covers extensive practice problems involving:
Conversions between metric, apothecary, and household systems
Dose calculations for multi-dose regimens
Time-based dosing and flow problems
Reading and constructing story problems from written prescriptions
Strategy tips:
Always convert all quantities to the units requested by the problem (e.g., mg, g, mL, or mL in a particular unit).
Simplify fractions first, then perform cross-multiplication.
Use flashcards for key conversions and drug classes.
Verify that final numbers are reasonable given the context (e.g., weight in kg roughly corresponds to pounds via 2.2).
XII. Pharmacology and Therapeutic Areas (High-Level Overview)
Antibiotics (examples and notes)
Penicillins: amoxicillin, ampicillin, penicillin V; cross-sensitivity with cephalosporins in some cases.
Cephalosporins: cefaclor, cephalexin, cefuroxime; similar safety concerns to penicillins; crest cross-sensitivity in some patients.
Macrolides: azithromycin, clarithromycin, erythromycin.
Tetracyclines: doxycycline, minocycline; photosensitivity; avoid with antacids/iron/calcium; tooth staining in children; avoid with pregnancy.
Fluoroquinolones: ciprofloxacin, levofloxacin, moxifloxacin; no dairy with some agents; interactions with divalent cations; photosensitivity risk.
Others: metronidazole, clindamycin, vancomycin, etc.
Anti-arrhythmics, cardiovasculars, and antihypertensives:
Class I–IV anti-arrhythmics; beta-blockers; calcium channel blockers; ACE inhibitors; ARBs; diuretics; potassium-sparing diuretics; nitrates.
Examples and notes on indications, interactions, and common auxiliary labels (e.g., no alcohol with metronidazole, potassium caution with ACE inhibitors).
Anti-diabetes, hormones, and HIV/AIDS therapies:
Insulin types (e.g., Regular, NPH, Lispro, Lantus); insulin storage considerations.
Oral hypoglycemics: metformin, glyburide, glipizide, pioglitazone, sitagliptin, etc.
HIV therapies: AZT/Retrovir, didanosine, lamivudine, protease inhibitors; the need for combination antiretroviral therapy (cART) and special counseling.
Anti-ulcer/antacids and GI agents:
H2 blockers (cimetidine, ranitidine, famotidine, nizatidine);
Proton pump inhibitors (lansoprazole, omeprazole, pantoprazole, esomeprazole, rabeprazole);
Antacids and absorption interactions; PPI and antibiotic interactions.
Other therapeutic areas:
Bronchodilators, corticosteroids for asthma; inhaled therapies; protective mouth rinses after inhaled steroids.
Analgesics (narcotics and non-narcotics), including opioid and non-opioid agents; considerations for drug interactions with anticoagulants like warfarin.
Psychiatric medications: antidepressants (TCAs, SSRIs, MAOIs), antianxiety agents (benzodiazepines), antipsychotics, and anti-Parkinson agents (e.g., Sinemet).
Vitamins and supplements; fat-soluble vitamins (A, D, E, K) vs water-soluble vitamins; B12 (cobalamin).
XIII. Pharmacy Law, Safety, and Regulatory References
Key acts and concepts:
FDA and OTC labeling requirements; drug safety and efficacy standards.
Durham-Humphrey Amendment: legend (Rx) vs non-legend (OTC) drugs; allows verbal orders and refills for some RX drugs; but requires prescriptions for legend drugs.
Kefauver-Harris Amendment: drug advertising, clinical trials, and safety/efficacy; requires GMP, etc.
Poison Prevention Packaging Act: child-resistant containers; some exceptions; labeling requirements for poison controls; keeps a poison log with purchaser details.
OSHA and MSDS: workplace safety; handling of hazardous materials; PPE and spill response.
OBRA 90: pharmacist duties; counseling; DUE (Drug Use Evaluation); ADR (adverse drug reaction) reporting; patient counseling requirements.
DEA and CSA: scheduling of controlled substances (CI–CV); Form 222 for CII ordering; inventory and destruction; 106 theft; 41 destruction forms; patient safeguarding.
Important regulatory items for exam:
DEA registration and Form 222 processes; triplicate copies; brown/green/blue copies; validity windows; lines per form; reporting; 3-year retention.
PPI requirements for certain medications (e.g., inhalers, isotretinoin, oral contraceptives, some devices).
Repackaging logs and 50% expiration rules; unit-dose labeling expectations.
CII refills: no refills; CIII–CV: up to 5 refills in 6 months; verbal orders require cover prescriptions.
Class II laminar flow hoods: clean, sterile technique; periodic inspection; 6 inches minimum working distance; aerosol containment; negative pressure for hazardous drugs; gowning and PPE requirements.
XIV. Practice Questions and Quick Reference (Representative Examples)
Quick-check style items (from classroom quizzes):
Identify prescription vs medication order; glass vs plastic vial; proper labeling elements; storage for specific drugs; which drugs require PPI; which drug classes end with -pril (ACE inhibitors); which drugs require potassium monitoring; etc.
Understand flow-rate problems (gtts/min, mL/hr); correct units; appropriate use of IV sets (drops per mL);
Know common antidotes and safety steps for IV spills; appropriate disposal of hazardous materials; sterile technique fundamentals.
DEA number validation steps: two letters (A/B) + 7 numbers; compute check digit using the standard formula; validate against the supervisor’s name and license.
OBRA counseling content: what information must be provided to the patient (drug name, dose, route, duration, side effects, storage, etc.).
XV. Quick Formulas and Reference Notes (LaTeX-formatted)
Temperature conversions:
Fahrenheit to Celsius:
Celsius to Fahrenheit:
Volume and weight conversions:
Dose and proportion rules:
Young’s Rule (child dose): (\text{Child dose} = \text{Age (years)} \times \frac{\text{Adult dose}}{\text{Age + 12}}) (illustrative; use the standard formula from your course materials)
Clark’s Rule (child weight-based): (\text{Child dose} = \frac{\text{Weight (lb)}}{150} \times \text{Adult dose})
Alligation Tic-Tac-Toe (summary):
Proportions: place highest in upper-left, lowest in lower-left, target in middle; subtract diagonally to get two numerators; denominator is the sum; each numerator/denominator gives proportion; multiply by total amount to obtain amounts of each ingredient.
Unit-dose labeling: essential fields (drug name/strength/form, lot, exp date, directions, storage, manufacturer, repack date, etc.).
Reconstitution and stability: reconstitute per product labeling; note shelf-life after reconstitution; refrigerate required drugs; some antibiotics require refrigeration; count on auxiliary labeling (shake well, refrigerate, etc.).
XVI. Commonly Tested Topics (Bottom-Line Highlights)
Distinctions you must know:
Prescription vs med order; refills; hospital vs outpatient labeling; patient profiles; referral to pharmacist.
Drug interactions (drug–drug, drug–disease, drug–food) and the pharmacist’s role in counseling.
Flow-rate problems and dose calculations using accurate unit conversions; ensure consistent units and correct time frames.
Regulatory framework: FDA labeling, OBRA counseling, Durham-Humphrey, Kefauver-Harris, Poison Prevention Packaging Act, CSA/DEA forms, and recall procedures.
Sterile compounding: Class 100 environment; horizontal vs vertical hood; aseptic technique; syringe/needle critical sites; IV admixtures and compatibility.
Inventory and purchasing: decentralized vs centralized systems; PAR value; “want book”; Just-in-Time purchasing; recalls.
Common drug-names categorization and safety labeling: penicillins vs cephalosporins cross-sensitivity; photosensitivity with certain antibiotics; avoiding certain drug interactions (e.g., warfarin with NSAIDs or aspirin).
XVII. Quick Reference (Key Facts to Memorize)
Basic dosing and label requirements:
FDA label essentials: pharmacy name/address, Rx number, date, prescriber, patient, directions, pharmacist initials, drug name/strength/form/quantity, expiration, manufacturer, lot, and refills.
Unit-dose repackaging expiration:
Expiration = 50% of stock bottle expiration; max 1 year.
DEA Form 222 basics:
Triplicate order; brown/green/blue copies; validity ~60 days; 10 lines per form; critical for CII ordering.
OBRA counseling requirements include: medication name, dose/dose form, route, duration, special directions/precautions, side effects, monitoring, storage, refill information, and what to do if dose is missed.
Common acronyms:
PPI: Patient Package Inserts (for certain medications)
GMP: Good Manufacturing Practices
USP-NF: Pharmacopoeia/National Formulary references
JCAHO: Joint Commission on Accreditation of Health Care Organizations (quality oversight)
PAR: Periodic automated replacement (inventory concept)
XVIII. Exam-Style Prompts (Practice)
From the classroom quizzes (sample insights):
Identify the meaning of common abbreviations (e.g., ss, qid, bid, prn, ac, pc, hs).
Determine which dosage forms are designed to dissolve in the intestines (e.g., enteric-coated tablets).
Identify the correct action for handling a spill of chemotherapy drugs in a vertical laminar hood.
Recognize which drugs require refrigeration; which are stored in the refrigerator or freezer.
Distinguish between two prescription formats and the appropriate processing steps (call doctor, fill correctly, etc.).
Miscellaneous but commonly tested: flow-rate problems, unit-dose calculations, and alligation challenges.
LaTeX-Formatted Quick Formulas (for easy reference in notes)
Temperature conversions:
Volume/weight conversions:
Alligation (conceptual): proportion = numerator/denominator, where numerator are diagonal differences in percentage strengths; multiply proportion by total volume to obtain volumes of each component.
Flow rate (IV) calculations:
where V = volume (mL), D = drops/mL, t = hours.Flow rate (to obtain mL/hr from gtt/min):
Summary
This set of notes consolidates the major and minor points from the transcript into structured study notes. It covers the three major content areas, the calculation/mathematics components, labeling and patient profiling requirements, regulatory frameworks, sterile compounding guidance, and practical problem-solving strategies. The content is organized to mirror the order and emphasis of the original material, with LaTeX-formatted formulas where applicable for exam-ready math.
End of notes.