Pass the PTCB CPhT PTCE Questions and answers with ExamsMirror

Risk Evaluation and Mitigation Strategies (REMS)areFDA-required programsto ensure that thebenefits of certain medications outweigh their risks. REMS programsrestrict prescribing, dispensing, and monitoringdue to the potential for serious side effects or misuse.

Suboxoneis used foropioid dependenceand containsbuprenorphine, apartial opioid agonist, which can causeaddiction, misuse, and respiratory depressionif used improperly.

REMS Requirements for Suboxone:

Prescriber Certification:Only specially certified providers can prescribe Suboxone.

Patient Education:Patients must be informed about the risks of misuse, overdose, and dependence.

Limited Dispensing:Pharmacists must ensure prescriptions meet REMS criteria before dispensing.

A. Xarelto (Rivaroxaban).→ Incorrect. While Xarelto is an anticoagulant, it isnot under REMS.

C. Warfarin.→ Incorrect. Warfarin requires monitoring butdoes not have a REMS program.

D. Haloperidol.→ Incorrect. Haloperidol is an antipsychotic, but itdoes not have a REMS program.

FDA REMS Program List (www.accessdata.fda.gov).

Suboxone REMS Guidelines (www.suboxonerems.com).

PTCB PTCE Exam Content Outline – REMS and Medication Safety.

Mosby’s Pharmacy Technician: Principles and Practice – REMS Regulations.

Why Is Suboxone (Buprenorphine/Naloxone) Under REMS?Why the Other Answer Choices Are Incorrect:Pharmacy Technician References:

ISMP maintains a “List of Confused Drug Names” highlighting look-alike/sound-alike name pairs with a history of mix-ups. Chlordiazepoxide (a benzodiazepine) and chlorpromazine (a typical antipsychotic) are a classic LASA pair on ISMP lists and in technician study materials, given their similar prefixes (“chlor…”) and length/appearance, leading to documented wrong-drug errors. While other pairs may also resemble one another, ISMP’s established examples include chlordiazepoxide/chlorpromazine specifically.

References (Pharmacy Technician documents / Study Guides):

• ISMP List of Confused Drug Names (community/inpatient).

• PTCB/ExCPT Medication Safety: LASA examples and tall-man lettering strategies.

• ASHP/ISMP LASA risk-reduction recommendations for selection, storage, and labeling.

Escitalopram (Lexapro)is aselective serotonin reuptake inhibitor (SSRI)used formajor depressive disorder (MDD) and generalized anxiety disorder (GAD). If escitalopram isnon-formulary, a suitable alternative would besertraline (Zoloft), anotherSSRIwith a similar mechanism of action and indication.

A. Cabergoline→ Incorrect; cabergoline is adopamine agonistused to treathyperprolactinemia, not depression or anxiety.

B. Ciprofloxacin→ Incorrect; ciprofloxacin is afluoroquinolone antibiotic, unrelated to antidepressant therapy.

D. Amantadine→ Incorrect; amantadine is anantiviral and antiparkinsonianagent, not used for depression.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmacology for Technicians – Nervous System Drugs)

Lexicomp Drug Monographs for SSRIs (Escitalopram & Sertraline)

Goodman & Gilman’s The Pharmacological Basis of Therapeutics

Amlodipine(10 mg) anddiltiazem(30 mg) are bothcalcium channel blockers (CCBs)used to treat hypertension and angina.

When a patient is prescribed two medications from the same therapeutic class, the pharmacy's prescription processing system may flag this as"therapeutic duplication."

This alert is meant toprevent potential adverse effectssuch as excessive lowering of blood pressure or heart rate.

A. Prior authorization required→ Not applicable unless the insurance requires special approval before covering the drug.

C. NDC not covered→ Would appear if the specific drug product (based on its National Drug Code) is not covered by insurance, but this scenario relates to duplication, not coverage.

D. Refill too soon→ This applies to refilling a medication before the allowed time frame, but the scenario describes a new prescription.

PTCB PTCE Exam Content Outline – Drug Interactions and Therapeutic Duplication

Lexicomp and Micromedex Drug Databases– Reference sources for drug classifications.

ISMP Guidelines on Preventing Therapeutic Duplication Errors

Why Other Answers Are Incorrect?Pharmacy Technician References:

According to theCDC Hand Hygiene Guidelines,alcohol-based hand sanitizershould be used:

Before and after direct patient contact(if hands are not visibly dirty).

Before and after wearing gloves(if no contamination is visible).

Before handling medication or sterile supplies.

A. Are about to touch a contaminated surface❌→Incorrect

Hand sanitizer should not be used before touching a contaminated surface.Instead, gloves should be worn, and hand hygiene should be performedaftertouching a contaminated surface.

B. Have just performed an aseptic task❌→Incorrect

Before aseptic tasks (e.g., preparing IV medications), soap and water or hand sanitizer is used.Afterward, contamination risk determines if sanitization is needed.

C. Are about to remove their gloves❌→Incorrect

Gloves do not completely prevent contamination; hand hygiene should be performedafterremoving gloves, not before.

CDC Guidelines for Hand Hygiene in Healthcare Settings– Recommends hand sanitizer use after patient contact.

USP <797> Sterile Compounding Guidelines– Reinforces aseptic hand hygiene practices.

PTCB PTCE Exam Content Outline– Covers infection control and proper use of hand hygiene techniques.

Why Not the Other Options?Key References:

AMaster Formulation Record (MFR)is adetailed document used in compounding pharmaciesto ensureconsistency, accuracy, and quality controlin preparing compounded medications.

An MFR includes:

Ingredients & amounts required.

Compounding procedures.

Stability and beyond-use dating (BUD).

Storage and labeling instructions.

This ensures that each compounded preparationmeets quality standardsand ismade correctly every time.

B. Prevent drug diversion❌→Incorrect

Drug diversion prevention involves security measures, inventory control, and trackingcontrolled substances, not MFRs.

C. Eliminate patient profiles❌→Incorrect

Patient profiles are essential for tracking medication history; MFRs are unrelated.

D. Guarantee drug availability❌→Incorrect

MFRs do not affect drug supply; they ensure accurate compounding.

USP <795> (Non-Sterile Compounding Guidelines)– RequiresMaster Formulation Records for all compounded preparations.

PTCB PTCE Exam Content Outline– Covers compounding procedures and quality control measures.

Why Not the Other Options?Key References:

In pharmacy practice and per USP/FDA conventions, when a manufacturer’s expiration date is expressed only as a month and year (e.g., “EXP 03/2026”), the product remains usable through the last day of that month. This standard is applied for product beyond-use and stock management, ensuring consistent interpretation across labeling and inventory control.

To determine how muchdrug (active ingredient)is in2 oz (ounces) of cream, we use the given ratio and perform unit conversions.

120 gof cream contains3 gof drug.

2 ozof cream =2 × 28.35 g(since1 oz = 28.35 g)

2 oz = 56.7 g

Step 1: Identify Given DataStep 2: Set Up a Proportion3 g drug120 g cream=x g drug56.7 g cream\frac{3 \text{ g drug}}{120 \text{ g cream}} = \frac{x \text{ g drug}}{56.7 \text{ g cream}}120 g cream3 g drug​=56.7 g creamx g drug​

Step 3: Solve forxxxx=3×56.7120=170.1120=1.42≈1.5 gx = \frac{3 \times 56.7}{120} = \frac{170.1}{120} = 1.42 \approx 1.5 \text{ g}x=1203×56.7​=120170.1​=1.42≈1.5 g

Thus,1.5 g of drugis present in2 oz of cream.

B. 6 g→ Incorrect; this would assume a higher drug concentration.

C. 15 g→ Incorrect; this is a miscalculation of the ratio.

D. 60 g→ Incorrect; far exceeds the total weight of the cream.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Pharmaceutical Calculations – Ratios and Proportions)

United States Pharmacopeia (USP) General Chapters on Compounding

The Pharmacy Technician’s Pocket Drug Reference

TheNational Drug Code (NDC)is a unique 10- or 11-digit number assigned to each drug product in the U.S.Understanding how NDC numbers are structuredis key to answering this question correctly.

The NDC format is as follows:XXXXX-YYYY-ZZ

First segment (XXXXX)→Labeler (Manufacturer or Distributor)

Second segment (YYYY)→Product Code (Specific Drug, Strength, and Formulation)

Third segment (ZZ)→Package Size (Quantity in the Package)

How to Find the Correct Answer?The given NDC:76439-103-10

76439= Manufacturer/Labeler Code

103= Product Code (Specific Drug & Strength)

10= Package Size

To matchthe same medication, theManufacturer (76439) and Product Code (103) must remain the same. Only thepackage size (last segment) can change.

A. 76439-208-10❌→Incorrect

Product Code (208) does not match (103).

B. 76439-103-50✅→Correct

Same manufacturer (76439) and same drug (103), but different package size (50 instead of 10).

C. 74693-103-10❌→Incorrect

Different manufacturer (74693 instead of 76439).

D. 74693-206-50❌→Incorrect

Different manufacturer (74693) and different product code (206).

FDA NDC Directory– Provides details on NDC structure and product identification.

PTCB PTCE Exam Content Outline– Covers NDC interpretation and drug identification.

Drug Supply Chain Security Act (DSCSA)– Reinforces correct medication identification using NDC.

Analyzing the Answer Choices:Key References:

Nurtec ODT (Rimegepant)is anorally disintegrating tablet (ODT)used for theacute treatment of migraines. Since it is designed to dissolve quickly in the mouth,it is highly sensitive to moisture. Exposure to moisture can cause the tablets to degrade, dissolve prematurely, or lose potency.

Storage Requirement:

Must be kept in the original blister packaging until usetoprevent moisture exposure.

Should not be stored in pill organizers or opened ahead of time.

B. Light→ Incorrect; Nurtec ODT isnot highly photosensitive.

C. Heat→ Incorrect; while heat can degrade many medications,moisture is the primary concernfor ODT formulations.

D. Cold→ Incorrect; refrigeration isnot required, and cold storage does not affect the drug’s stability.

Other Answer Choices Explained:References:

FDA Drug Label for Nurtec ODT (Rimegepant) – Storage and Handling Instructions

USP <795> Nonsterile Compounding & Drug Stability Guidelines

PTCB PTCE Exam Content Outline (Medication Storage & Handling)