Pharmacy Tech — the credentialing body practice for the Pharmacy Tech credential

A patient is taking lisinopril 20 mg daily and develops a persistent dry cough. The pharmacist recommends switching to an ARB. Which is the most appropriate substitute?

1. Atenolol
2. Amlodipine
3. Losartan
4. Hydrochlorothiazide

Answer: C — Losartan

ARBs end in '-sartan' and act on the same RAAS pathway without bradykinin accumulation that causes ACE-I cough. A) Beta blocker. B) Calcium channel blocker. D) Thiazide diuretic.

Methadone for opioid use disorder must be dispensed from:

1. Any retail pharmacy
2. Mail-order only
3. Hospital ER only
4. Federally certified Opioid Treatment Programs (OTPs)

Answer: D — Federally certified Opioid Treatment Programs (OTPs)

Methadone for OUD is restricted to SAMHSA-certified OTPs. Methadone for pain can be dispensed at retail with a CII Rx. A/C/B) Incorrect.

Which antibiotic class carries an FDA boxed warning for tendon rupture and aortic dissection?

1. Macrolides
2. Tetracyclines
3. Fluoroquinolones
4. Sulfonamides

Answer: C — Fluoroquinolones

Fluoroquinolones (ciprofloxacin, levofloxacin) have boxed warnings for tendinitis/rupture, peripheral neuropathy, and aortic events. A/B/D) Different safety profiles.

Which document authorizes a pharmacy technician to assume responsibilities normally requiring the pharmacist?

1. Power of attorney for DEA Form 222 ordering
2. A signed CE certificate
3. HIPAA training certificate
4. Tech-Check-Tech is universal in all states

Answer: A — Power of attorney for DEA Form 222 ordering

A DEA Form 222 POA lets a tech sign for CII orders. State scope laws also govern tech-check-tech and similar tasks. B/C) Not authorization. D) State-specific, not universal.

Partial filling of a CII prescription is allowed federally when:

1. The patient or prescriber requests it, with remainder filled within 30 days
2. Never
3. Only for terminal patients
4. Only with DEA approval

Answer: A — The patient or prescriber requests it, with remainder filled within 30 days

The CARA Act of 2016 allowed partial fills of CII at patient/prescriber request, balance within 30 days. B) Outdated. C) Old LTCF/terminal rule expanded. D) Not required.

Which DEA Schedule allows NO refills, requiring a new written prescription each time?

1. Schedule II
2. Schedule III
3. Schedule IV
4. Schedule V

Answer: A — Schedule II

A) Correct — Schedule II (oxycodone, morphine, Adderall) does not allow refills; new Rx required each fill. B/C) Allow up to 5 refills in 6 months. D) Even less restrictive.

Tall Man lettering for 'hydroxyzine' vs 'hydralazine' is written as:

1. hydroxyzine vs hydralazine
2. hydrOXYzine vs hydrALAZINE
3. HYDROXYZINE vs HYDRALAZINE
4. Hydroxyzine vs Hydralazine

Answer: B — hydrOXYzine vs hydrALAZINE

ISMP capitalizes the distinguishing portion of LASA names. A) No emphasis. C) Yelling, less effective. D) Title case, no differentiation.

Hand hygiene before sterile compounding must include washing for at least:

1. 5 seconds
2. 30 seconds with antimicrobial soap, up to the elbows
3. 5 minutes
4. Hand sanitizer is enough

Answer: B — 30 seconds with antimicrobial soap, up to the elbows

USP 797 specifies thorough wash up to the elbows. A) Too short. C) Excessive. D) Sanitizer alone insufficient before garbing.

ISMP recommends avoiding which abbreviation?

1. U (for units) — should write 'units' instead
2. BID
3. PO
4. mL

Answer: A — U (for units) — should write 'units' instead

A/C/D) Safe abbreviations. A) Correct — 'U' looks like 0 or 4 in handwriting. Always write 'units' out per ISMP.

A pharmacy's auto-refill program automatically processes refills for enrolled patients. What safeguard is essential to prevent medication waste and missed non-adherence signals?

1. Enrolling all patients by default without opt-in
2. Auto-refilling controlled substances the same as non-controlled drugs
3. Periodically confirming with the patient that the medication is still needed and being taken before each auto-refill is filled
4. Eliminating the pharmacist verification step to speed processing

Answer: C — Periodically confirming with the patient that the medication is still needed and being taken before each auto-refill is filled

A) Common misconception — opt-in patient consent, not default enrollment, is the accepted practice standard. B) Wrong — many auto-refill programs specifically exclude controlled substances from automatic processing. C) Correct. D) Wrong — pharmacist verification is still required regardless of automation.

When entering a prescription into the system, the technician's responsibility includes:

1. Final verification of clinical appropriateness
2. Accurate transcription of drug, strength, sig, quantity, refills, prescriber NPI/DEA
3. Counseling the patient
4. Accepting verbal CII orders

Answer: B — Accurate transcription of drug, strength, sig, quantity, refills, prescriber NPI/DEA

Tech enters; pharmacist verifies clinically. A) Pharmacist only. C) Pharmacist only. D) Pharmacist only.

A sig 'i gtt OU q4h' translates to:

1. 1 tablet by mouth every 4 hours
2. 1 drop in each eye every 4 hours
3. 1 capsule in the right ear every 4 hours
4. 1 mL IV every 4 hours

Answer: B — 1 drop in each eye every 4 hours

gtt = drop, OU = both eyes, q4h = every 4 hours. A) Wrong route. C) AD = right ear. D) Wrong route entirely.

Insulin types — onset/peak/duration: Rapid-acting?

Lispro, aspart, glulisine. Onset 5-15 min, peak 30-90 min, duration 3-5 hr.

Look-Alike-Sound-Alike (LASA) drugs — example?

Hydroxyzine vs hydralazine; Celebrex vs Celexa; Lasix vs Losec. Use Tall Man Lettering (hydrOXYzine vs hydrALAZINE).

Common suffix '-olol'?

Beta blockers (metoprolol, atenolol). HTN, arrhythmia, angina, post-MI.

TID?

Three times daily.

Common suffix '-cillin'?

Penicillin antibiotics (amoxicillin, ampicillin). Bacterial infections.

DEA Schedule V?

Lowest abuse potential. Cough syrups with codeine, pregabalin, diphenoxylate/atropine.