Questions for the PTCE were updated on : Nov 21 ,2025
While compounding anonsterile preparation, physical incompatibilities may be avoided by following
the specific mixing instructions found in the:
B
Explanation:
The Master Formulation Record (MFR) is a standardized document that provides step-by-step
instructions on how to compound a specificnonsterile preparation.
It includes:
Active and inactive ingredients
Mixing instructions
Equipment needed
Beyond-use dating (BUD)
Storage requirements
Why Other Options Are Incorrect:
❌
A . Medication Guide?
Intended for patient information, not compounding.
❌
C . Patient Package Insert?
Explains medication use but doesn’t contain compounding instructions.
❌
D . Safety Data Sheet (SDS)?
Contains safety and hazard information, not formulation instructions.
Reference:USP <795> Nonsterile Compounding Standards, PTCB Compounding Study Guide.
TheResource Conservation and Recovery Act (RCRA)considers which of the following to beU-listed
hazardous waste?
D
Explanation:
RCRA categorizes hazardous pharmaceutical waste into P-list, U-list, and D-list.
Cyclophosphamide is a U-listed hazardous waste because it is a chemotherapy drug known to be
toxic to the environment.
Proper disposal is required to prevent contamination.
Why Other Options Are Incorrect:
❌
A . Dorzolamide?
Not hazardous, used for glaucoma.
❌
B . Bicalutamide?
An anti-androgen, but not U-listed.
❌
C . Acetazolamide?
A diuretic, not hazardous.
Reference:EPA RCRA Drug Disposal Guidelines, USP <800> Hazardous Drug List.
If atoxic materialcomes in contact with theskin or eyes, the immediate response should be to:
D
Explanation:
USP <800> mandates that hazardous drug exposure requires immediate decontamination.
Flushing the affected area with large amounts of water for at least 15minutes is the first step.
For eye exposure, an eye wash station must be used immediately.
Why Other Options Are Incorrect:
❌
A . Writing a report first?
Incident reports should be done AFTER flushing the area.
❌
B . Ice bag?
Ice can worsen chemical burns.
❌
C . Soapy water?
Soap may react with chemicals, causing further irritation.
Reference:USP <800> Hazardous Drug Handling, OSHA Chemical Safety Guidelines.
Which of the followingdeviceswould be most appropriate to dispense for a patient to use with
theirAsmanex HFA?
B
Explanation:
Asmanex HFA (Mometasone) is an inhaled corticosteroid used for asthma.
A spacer improves medication delivery by holding the medication in a chamber, allowing better lung
absorption.
This is especially important for children and elderly patients.
Why Other Options Are Incorrect:
❌
A . Nebulizer?
Not needed for an HFA inhaler; used for liquid medications.
❌
C . Ventilator?
Used for mechanical breathing, not asthma maintenance.
❌
D . Glucometer?
Used for blood sugar monitoring, unrelated to inhalers.
Reference:Global Initiative for Asthma (GINA) Guidelines, PTCB Respiratory Medication Guidelines.
Adult and pediatric strengths of the same vaccine are often packaged similarly.As a safety precaution,
theCDCrecommends that pharmacies do which of the following?
C
Explanation:
Vaccines come in different strengths for adults and children, and mix-ups can lead to underdosing or
overdosing.
Storing pediatric and adult vaccines separately within the refrigerator reduces the risk of errors.
Example:PediatricCOVID-19 vaccines (lower dose) and adult doses look similar but have different
concentrations.
Why Other Options Are Incorrect:
❌
A . Repackaging?
Against CDC and USP <797> guidelines, which require vaccines to remain in their
original packaging.
❌
B . Ordering from different manufacturers?
Not practical; most pharmacies use a single supplier
for consistency.
❌
D . Automated dispensing systems?
Not always available for vaccines.
Reference:CDC Vaccine Storage & Handling Guidelines, ISMP Vaccine Safety Best Practices.
Thegeneric name for Concertais:
A
Explanation:
Concerta = Methylphenidate (extended-release) used for ADHD.
Other ADHD drugs:
Dexmethylphenidate = Focalin
Dextroamphetamine = Adderall
Lisdexamfetamine = Vyvanse
Reference:FDA ADHD Drug Classifications, PTCB Medication Guide.
Pharmacies may dispense a supply ofisotretinointhat will last no more than how many days?
B
Explanation:
Isotretinoin (Accutane) is regulated under the iPLEDGE program.
Only a 30-day supply is allowed, and pregnancy tests are required each month for females.
Reference:FDA iPLEDGE Program, PTCB High-Risk Medication Guidelines.
According to theDEA, how often must aphysical inventory of all controlled substancesbe performed?
D
Explanation:
DEA requires a full inventory of all controlled substances every 2 years (biennial inventory).
Schedule II drugs requirea separate recordfrom Schedules III–V.
Reference:DEA Controlled Substance Inventory Regulations (21 CFR 1304.11).
Medications considered to have anarrow therapeutic index (NTI)generally exhibita(n):
D
Explanation:
NTI drugs have small differences between effective and toxic doses.
Examples:Warfarin, Digoxin, Lithium, Theophylline.
Requires close monitoring (lab tests, dose adjustments).
Reference:FDA NTI Drug List, PTCB Medication Safety Guidelines.
A patient picking up a prescription forrisedronatemust receive aMedication Guidebecause the
medication can cause:
A
Explanation:
Risedronate (Actonel) is a bisphosphonate used for osteoporosis.
It can causehypocalcemia (low calcium levels)byinhibiting bone resorption.
Patients must take it witha full glass of water and remain upright for 30 minutesto
preventesophageal irritation.
Reference:FDA Bisphosphonate Warnings, PTCB Drug Counseling Guidelines.
Antacids that contain calcium carbonatemay decrease the serum concentration of:
D
Explanation:
Calcium carbonate binds to doxycycline, preventing its absorption, reducing its effectiveness.
Doxycycline is a tetracycline antibiotic used for bacterial infections.
Patients should take doxycycline 1–2 hours before or after antacids.
Reference:FDA Drug Interaction Guidelines, PTCB Medication Absorption Guide.
Patients takingbudesonide oral capsules or tabletsshould avoid ingesting:
A
Explanation:
Grapefruit juice inhibits CYP3A4 enzymes, increasingbudesonide levels inthe blood, leading tohigher
risk of side effects (immune suppression, adrenal insufficiency).
Budesonide is a corticosteroid used for Crohn’s disease and asthma.
Why Other Options Are Incorrect:
❌
B . Dairy products?
No significant interaction.
❌
C . Leafy greens?
Affectswarfarin (not budesonide).
❌
D . Aged cheese?
Interacts withMAO inhibitors, not budesonide.
Reference:FDA Drug-Food Interaction Guide, PTCB Medication Safety Guidelines.
Thegeneric namefor5-FUis:
D
Explanation:
5-FU (Fluorouracil) is a chemotherapy drugused forcolon, breast, and skin cancers.
It is apyrimidine analogthatprevents cancer cell DNA replication.
Why Other Options Are Incorrect:
❌
A . Fluocinonide?
Topical corticosteroid for skin conditions.
❌
B . Fluoxetine (Prozac)?
SSRI antidepressant.
❌
C . Fluocinolone?
Topical corticosteroid.
Reference:National Cancer Institute Chemotherapy Guide, PTCB Oncology Medications.
According to theDEA, medications in all fivecontrolled substance schedules:
A
Explanation:
Controlled substances (Schedules I–V) are classified by the DEA based on their potential for abuse,
medical use, and dependence risk.
Schedule I (highest risk, no medical use):Heroin, LSD, Ecstasy.
Schedule II (high abuse potential, medical use):Oxycodone, Morphine, Fentanyl.
Schedule III (moderate abuse potential):Codeine combinations, Ketamine.
Schedule IV (low abuse potential):Alprazolam, Zolpidem.
Schedule V (lowest risk):Cough syrups with low doses of codeine.
Why Other Options Are Incorrect:
❌
B . All contain hydrocodone?
OnlySchedule II and IIImay contain hydrocodone.
❌
C . FDA-approved indications?
Schedule I drugs haveno FDA-approved medical use.
❌
D . Insurance verification?
Not all controlled drugs require insurance verification.
Reference:DEA Controlled Substance Act, PTCB Controlled Substances Guide.
Which of the following medications is ahormonethat would be appropriate for pharmacies todispose
of as hazardous waste?
C
Explanation:
Norethindrone is a synthetic progestin hormone found in oral contraceptives.
Hormones and chemotherapy drugs must be disposed of as hazardous pharmaceutical waste per EPA
and USP <800> guidelines.
Reference:EPA Hazardous Drug Disposal Regulations, USP <800> Hazardous Drug List.