Free Practice Questions for PTCB PTCE Exam

Linaclotide (brand name: Linzess)must be dispensed in its original containerbecause:

It is highly moisture-sensitive, and removing it from its original container may lead to degradation.

The manufacturer provides a desiccantin the original packaging toprotect against humidity.

A. Furosemide❌→Does not require original container.

While furosemide tablets should be stored properly,they do not require dispensing in the original container.

C. Valsartan❌→Does not require original container.

Valsartan tablets arestable outside the original container.

D. Sertraline❌→Does not require original container.

Sertraline (Zoloft)can be repackagedwithout stability issues.

FDA Linzess Storage Guidelines– States that Linzessmust be stored in its original container with desiccant.

USP <797> & <800> Guidelines– Cover proper storage and handling of moisture-sensitive drugs.

PTCB PTCE Exam Content Outline– Includes special drug storage requirements.

Why Not the Other Options?Key References:

Ciprofloxacin is afluoroquinolone antibioticthat chelates (binds) withdivalent and trivalent cationssuch ascalciumfound in milk. This interaction forms aninsoluble complex, significantly reducing ciprofloxacin’s absorption in the gastrointestinal (GI) tract, leading to decreased bioavailability and reduced therapeutic effect.

B. Distribution→ Incorrect; milk does not directly impact the distribution of ciprofloxacin in the bloodstream.

C. Metabolism→ Incorrect; ciprofloxacin is primarily metabolized in the liver, and milk does not inhibit its enzymatic breakdown.

D. Excretion→ Incorrect; ciprofloxacin is mainly excreted by the kidneys, and milk does not significantly impact this process.

Other Answer Choices Explained:Pharmacist’s Recommendation:Patients should take ciprofloxacinat least 2 hours before or 6 hours afterconsuming dairy products to avoid reduced drug absorption.

References:

PTCB PTCE Exam Content Outline (Pharmacokinetics & Pharmacodynamics)

Lexicomp Drug Interactions Database

FDA Ciprofloxacin Drug Label & Administration Guidelines

Goodman & Gilman’s The Pharmacological Basis of Therapeutics

Linagliptin is thegeneric name for Tradjenta, a medication used to treattype 2 diabetes mellitus.

Linagliptin is a DPP-4 inhibitor (Dipeptidyl Peptidase-4 Inhibitor).

Works byincreasing incretin levels, which boost insulin secretion and reduce glucagon levels.

Used tolower blood glucose levelsin patients with type 2 diabetes.

(A) Forteo❌Incorrect – Forteo (teriparatide) is for osteoporosis.

(B) Januvia❌Incorrect – Januvia (sitagliptin) is another DPP-4 inhibitor but not the same as Tradjenta.

(C) Tradjenta✅Correct – The brand name for linagliptin.

(D) Xarelto❌Incorrect – Xarelto (rivaroxaban) is an anticoagulant.

Tradjenta Prescribing Information (FDA):https://www.tradjenta.com

American Diabetes Association (ADA) – Pharmacologic Approaches to Diabetes Management:https://diabetesjournals.org

PTCB Exam Content Outline – Brand & Generic Name Drug Recognition

Drug Classification & Mechanism:Analysis of Answer Choices:References for Pharmacy Technicians:

Butorphanolis aSchedule IV controlled substanceunder theControlled Substances Act (CSA). It is anopioid analgesicused formoderate-to-severe painandmigraine relief. Due to itsabuse potential, it is classified as acontrolled substanceand requires special handling in pharmacies.

A. Metoprolol→ Incorrect; metoprolol is abeta-blockerforhypertension and heart diseaseand isnot a controlled substance.

C. Carvedilol→ Incorrect; carvedilol is also abeta-blockerforheart failure and hypertension, not a controlled drug.

D. Propranolol→ Incorrect; propranolol is abeta-blockerused forhypertension, migraines, and anxiety, but it isnot a controlled substance.

Other Answer Choices Explained:References:

DEA Controlled Substances List (Schedule IV – Butorphanol)

PTCB PTCE Exam Content Outline (Pharmacy Laws & Regulations – Controlled Substances)

Federal Controlled Substances Act (CSA)

Breaking Down the SIG Code:"Sig: 1 tab PO q.i.d. p.c. & h.s."

Abbreviation

Meaning

1 tab

Take one tablet

PO

By mouth (oral route)

q.i.d.

Four times daily

p.c.

After meals (post cibum)

h.s.

At bedtime (hora somni)

"Take one tablet by mouth four times daily after meals and at bedtime."✅

(A) Take one tablet by mouth five times daily with meals and at bedtime.❌Incorrect – "q.i.d." means four times daily, not five.

(B) Take one tablet by mouth four times daily without meals and at bedtime with a snack.❌Incorrect – "p.c." meansafter meals, not without meals.

(C) Take one tablet by mouth four times daily before meals and at bedtime.❌Incorrect – "p.c." meansafter meals, not before.

(D) Take one tablet by mouth four times daily after meals and at bedtime.✅Correct – Matches the SIG interpretation.

ISMP List of Common SIG Codes and Abbreviations:https://www.ismp.org

PTCB Exam Content Outline – Prescription Interpretation & SIG Code Reading

Putting It Together:Analysis of Answer Choices:References for Pharmacy Technicians:

TheVaccine Adverse Event Reporting System (VAERS)is a national system managed by theCDC and FDAto monitoradverse events following vaccination.

Anaphylaxisis asevere, life-threatening allergic reactionthat must beimmediately reported to VAERS, as it is a known but rareserious vaccine side effect.

Other serious events likeGuillain-Barré syndrome, myocarditis, and seizuresalso require VAERS reporting.

A. Constipation→ Incorrect;not a serious vaccine-related event.

C. Drowsiness→ Incorrect; commonbut not severeenough to require VAERS reporting.

D. Hyperlipidemia→ Incorrect;unrelated to vaccines.

Other Answer Choices Explained:References:

CDC VAERS Reporting Criteria for Adverse Vaccine Reactions

FDA Vaccine Safety Monitoring Guidelines

PTCB PTCE Exam Content Outline (Immunizations & Adverse Drug Event Reporting)

Look-alike/sound-alike (LASA) medications are drugs that areeasily confused due to similar spelling or pronunciation, which increases the risk of medication errors.

Citalopram(Celexa) →Selective serotonin reuptake inhibitor (SSRI) used for depression

Celecoxib(Celebrex) →Nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation

Why Are Citalopram and Celecoxib Considered LASA?Both drugs sharesimilar spelling and pronunciation, increasing the chance of errors inprescribing, dispensing, and administration.

Example of potential errors: A patient withdepressionmay mistakenly receiveCelecoxib (NSAID)instead ofCitalopram (antidepressant), leading to untreated depression and unnecessary NSAID use.

A. Lisinopril and Metoprolol❌→Different drug classes, butnot commonly confused.

Lisinopril(ACE inhibitor for blood pressure)

Metoprolol(Beta-blocker for blood pressure and heart conditions)

C. Acebutolol and Acetazolamide❌→Although their names look similar, they haveless common confusion in clinical practice.

Acebutolol(Beta-blocker)

Acetazolamide(Diuretic for glaucoma, altitude sickness)

D. Naproxen and Misoprostol❌→These are oftenprescribed togetherbut arenot confused with each other.

Naproxen(NSAID for pain)

Misoprostol(Used to protect the stomach from NSAID-induced ulcers)

Institute for Safe Medication Practices (ISMP) LASA List– ConfirmsCitalopram and Celecoxibas common look-alike/sound-alike drugs.

PTCB PTCE Exam Content Outline– Covers error prevention strategies, including LASA medications.

FDA Medication Error Prevention Guidelines– Recommends usingTall Man Lettering(e.g.,CeleXib vs. CitaloPram) to differentiate LASA drugs.

Why Not the Other Options?Key References:

To determine theweight/weight (w/w) percentage strength, use the formula:

\text{w/w % strength} = \left( \frac{\text{Mass of Active Ingredient (g)}}{\text{Total Mass of Final Product (g)}} \right) \times 100

Given:

Mass of zinc oxide (active ingredient) = 4.5 g

Total mass of final ointment = 30 g

\text{w/w % strength} = \left( \frac{4.5}{30} \right) \times 100 =0.15×100= 0.15 \times 100=0.15×100 =15%= 15\%=15%

(A) 0.25%❌Incorrect – This is too low.

(B) 10%❌Incorrect – This would be true if 3 g of zinc oxide were used in 30 g total.

(C) 15%✅Correct – The calculation confirms this answer.

(D) 17.5%❌Incorrect – This would be true if 5.25 g of zinc oxide were used in 30 g total.

Pharmaceutical Calculations, 15th Edition– Howard C. Ansel

The United States Pharmacopeia (USP) Chapter <795>– Compounding Non-Sterile Preparations

PTCB Exam Content Outline – Pharmaceutical Calculations

Analysis of Answer Choices:References for Pharmacy Technicians:

The abbreviation"PO"means"by mouth" (per os).

The abbreviation"ac"stands for"before meals" (ante cibum).

The phrase"daily for 14 days"indicates that the patient should take the medication once a day for a total of 14 days.

Thus, the correct label instructions should be:"Take one capsule by mouth before a meal once daily for 14 days."

PTCB PTCE Exam Content Outline – Prescription Interpretation– Covers standard medical abbreviations.

ISMP (Institute for Safe Medication Practices) List of Common Pharmacy Abbreviations– Defines "PO" (by mouth) and "ac" (before meals).

USP Medication Labeling Standards– Ensures clear and accurate patient instructions.

Pharmacy Technician References: