Free Practice Questions for PTCB PTCE Exam

Experiencingphotosensitivity(increased sensitivity to sunlight) as a result of takingciprofloxacinis an example of anadverse drug reaction (ADR). Thisunexpectedandundesirableeffect occurs in some individuals due tofluoroquinolones causing cellular damage from UV exposure.

A. Intended effect→ Incorrect; the intended effect of ciprofloxacin isbacterial infection treatment, not photosensitivity.

C. Synergistic effect→ Incorrect; asynergistic effectoccurs whentwo drugs work togetherto produce a greater effect, which is not the case here.

D. Anaphylactic reaction→ Incorrect;anaphylaxisis asevere allergic reactionwithrespiratory distress, hypotension, and swelling, not photosensitivity.

Other Answer Choices Explained:References:

PTCB PTCE Exam Content Outline (Medication Safety & Side Effects)

Lexicomp Drug Monograph for Ciprofloxacin

FDA Fluoroquinolone Safety Warnings

Nitroglycerin sublingual tablets are light- and moisture-sensitive, requiring storage in tight, light-resistant containers. Removing them from their original glass container can compromise potency. Therefore, they must always be dispensed in the original container provided by the manufacturer.

According to USP Packaging and Storage Requirements and Mosby’s Pharmacy Technician:

“Nitroglycerin SL tablets lose potency quickly when exposed to air or light. Do not repackage; dispense only in manufacturer-supplied container.”

Other options do not require original container for stability:

Methotrexate – may be repackaged

Metoprolol XL – stable in unit-dose or amber vials

Allopurinol – routine packaging allowed

Incompatibility in a nonsterile compound can be identified through various physical, chemical, and therapeutic changes.An unexpected change in odoris a key indicator of chemical instability, contamination, or degradation of a compounded preparation. Some ingredients may break down into volatile compounds, leading to noticeable odor changes.

A. A clear solution→ Incorrect; clarity alone does not indicate incompatibility.Some solutions may be clear but still chemically unstable.

B. The use of a pH buffer system→ Incorrect; buffer systems are used to maintain pH stability and prevent incompatibility rather than indicate it.

D. Suspension particles settling to the bottom of a container→ Incorrect; suspensions naturally settle and require shaking before use.This is not necessarily a sign of incompatibility.

Other Answer Choices Explained:References:

USP <795> Pharmaceutical Compounding—Nonsterile Preparations

PTCB PTCE Exam Content Outline (Medication Safety & Quality Assurance)

Remington: The Science and Practice of Pharmacy

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A medication'sstabilityrefers tohow well it maintains potency, effectiveness, and safety over time. Several factors candegrade medications, includingoxygen, moisture, temperature, and light.

Oxygen exposurecan causeoxidation, leading to drug degradation and loss of potency.

Many medications, especiallyvitamins (e.g., vitamin C), biologics, and certain antibiotics, are susceptible to oxidative damage.

Medications requiring protection from oxygen are often packaged inair-tight containersorblister packs.

A. Allergies→ Incorrect; allergies affect thepatient, not the drug’sstability.

B. Equivalence→ Incorrect; equivalence refers tobioavailabilitybetween generic and brand-name drugs, not drug stability.

D. Indications→ Incorrect; indications refer toapproved uses of a drug, not factors affecting its stability.

Other Answer Choices Explained:References:

USP <797> and <795> Guidelines on Medication Stability

FDA Drug Stability and Shelf Life Guidelines

PTCB PTCE Exam Content Outline (Medication Storage & Stability)

• Enbrel (etanercept) is a biologic that requires refrigeration at 2–8°C (36–46°F) prior to dispensing and during storage per manufacturer labeling.

• Testosterone injections (e.g., cypionate/enanthate) are typically stored at controlled room temperature.

• Lovenox (enoxaparin) prefilled syringes and heparin injections are also stored at controlled room temperature; refrigeration is not required.

Therefore, the injection that must be refrigerated is Enbrel.

References (Pharmacy Technician Documents/Study Guides):

• Storage and stability in manufacturer labeling for biologics and injectables; pharmacy technician references on refrigerated biologics (e.g., etanercept) vs. room-temperature injectables (testosterone, enoxaparin, heparin).

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.

Lipitor is the brand name forAtorvastatin, aHMG-CoA reductase inhibitor (statin)used to lower cholesterol and reduce the risk of cardiovascular disease.

(A) Provastatin❌Incorrect –Misspelled, should bePravastatin(Pravachol).

(B) Fluvastatin❌Incorrect – Fluvastatin (Lescol) is another statin, but not the generic for Lipitor.

(C) Simvastatin❌Incorrect – Simvastatin (Zocor) is a statin but not the generic for Lipitor.

(D) Atorvastatin✅Correct – The generic name for Lipitor.

Analysis of Answer Choices:Statins & Their Brand Names:Generic Name

Brand Name

Atorvastatin

Lipitor✅

Simvastatin

Zocor

Pravastatin

Pravachol

Fluvastatin

Lescol

Rosuvastatin

Crestor

Lovastatin

Mevacor

Lipitor Prescribing Information: https://www.pfizer.com/products/product-detail/lipitor

PTCB Exam Content Outline – Generic & Brand Name Drug Recognition

Pharmacology for Pharmacy Technicians, 3rd Edition – Perspective on Statin Medications

References for Pharmacy Technicians:

According tofederal law,a reverse distributor must issue a DEA Form 222 (or electronic equivalent) when a pharmacy requests the destruction of a Schedule II controlled substance.

Reverse distributorshandle the return and disposal ofexpired, damaged, or unusable controlled substances.

DEA Form 222 (or CSOS, the electronic equivalent) is required for Schedule II drugs.

Hydrocodone with acetaminophen (e.g., Norco, Vicodin)is aSchedule II controlled substance, requiringDEA Form 222for reverse distribution.

A. Acetaminophen with codeine❌→Schedule III

Does not require DEA Form 222; instead, DEA Form 41 is used for disposal.

C. Promethazine with codeine❌→Schedule V

Lower abuse potential; does not require DEA Form 222.

D. Pseudoephedrine with ibuprofen❌→Not a controlled substance

Pseudoephedrine is regulated under the Combat Methamphetamine Epidemic Act (CMEA), not the DEA controlled substance schedules.

DEA Controlled Substances Act (CSA)– Confirms thatSchedule II drugs require DEA Form 222 for reverse distribution.

PTCB PTCE Exam Content Outline– Covers controlled substances and reverse distribution requirements.

DEA Diversion Control Division Guidelines– Listshydrocodone as a Schedule II drug requiring Form 222 for disposal.

Understanding DEA Form 222 and Reverse Distribution:Why is Hydrocodone with Acetaminophen the Correct Answer?Why Not the Other Options?Key References:

Lamivudine (Epivir)is anantiretroviral agent used to treat HIV/AIDS and hepatitis B. Some antiretroviral drugs are classified ashigh-alert medications in certain healthcare settingsbecause:

Dosing errors can lead to treatment failure or resistance.

Severe side effects and toxicities may occur if misused.

TheInstitute for Safe Medication Practices (ISMP)includes some antiretrovirals in theirhigh-alert medication list, especially in hospitals.

A. Meperidine❌→Not an antiretroviral; it's a narcotic analgesic (opioid pain reliever).

B. Olopatadine❌→Not an antiretroviral; it's an antihistamine (used for allergies).

D. Tizanidine❌→Not an antiretroviral; it's a muscle relaxant.

ISMP High-Alert Medication List– Includes certainantiretroviral drugs as high-alert medications in some settings.

FDA Drug Labeling for Lamivudine (Epivir)– ListsHIV/AIDS and Hepatitis B as indications.

PTCB PTCE Exam Content Outline– Covers high-alert medications and their risks.

Why Not the Other Options?Key References:

Alot numberis a unique identifier assigned to a specific batch of a medication during manufacturing.

TheNational Drug Code (NDC)andserial numberare different from the lot number.

On medication stock bottles, the lot number is often preceded by"(10)", which is present in this case:

(10)ABC123→This represents the lot number.

B. 55555444422→ This appears to be aGTIN (Global Trade Item Number), which identifies the product but is not the lot number.

C. 051526→ This could represent a manufacturer’s internal code or part of the packaging details, but not the lot number.

D. 11262026→ This follows the(21) identifier, which represents theexpiration date (November 26, 2026).

PTCB PTCE Exam Content Outline – Medication Labeling and Lot Numbers

FDA Drug Supply Chain Security Act (DSCSA)– Provides guidance on tracking drug batches.

USP Chapter <1079> Good Storage and Distribution Practices– Covers stock bottle labeling and identification.

Why Other Answers Are Incorrect?Pharmacy Technician References: