Delmar's pharmacy technician certification exam review

288 Pages·2000·18.85 MB·English

by  Anthony, Patricia K

Delmar’s Pharmacy Technician
Certification Exam Review
by
Patricia K. Anthony, Ph.D.
Research Associate
The University of Arizona
formerly
Instructor of Pharmacy Technology
Tuscon Campus
Pima Medical Institute
Tuscon, Arizona
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Library of Congress Cataloging-in-Publication Data
Anthony, Patricia K.
Delmar’s pharmacy technician certification exam review / by
Patricia K. Anthony
p. cm.
Includes bibliographical references and index.
ISBN 0-7668-0743-6
1. Pharmacy technician’s examinations, questions, etc. 2. Pharmacy
technician’s outlines, syllabi, etc. I. Title. II. Title:
Certified pharmacy technician examination review.
[DNLM: 1. Pharmacists’ Aides Examination Questions. 2. Pharmacy
Examination Questions. QV 18.2 A628d 1999]
RS122.95.A585 1999
615'.1'078—dc21
DNLM/DLC
for Library of Congress 99-25102
CIP
Contents
Preface vii
Acknowledgments viii
Introduction ix
Section I Assisting the Pharmacist in Serving Patients 1
Chapter 1 Receiving the Medication Order 3
The Medication Order 5
The Medication Administration Record 9
Comparison of Medication Orders in Retail and
Institutional Settings 11
Chapter 2 Processing the Medication Order 15
Basic Terminology—The Dosage Form and Instructions 16
Routes of Administration 17
Interpreting the Order 18
Dispensing the Correct Medication 23
Comparison of Drug Dispensing in Retail and
Institutional Settings 23
Chapter 3 Preparation and Utilization of the Patient Profile 27
Obtaining and Entering Patient Information 28
Comparison of Patient Profiles in Institutional and
Retail Settings 30
Chapter 4 Handling Medications 35
Use of the Manufacturer’s Label to Correctly Dispense
Medication 36
Packaging and Labeling the Medication 37
Dispensing Liquid Medications 38
Intravenous Admixtures and Injections 41
Auxiliary Labels 42
Chapter 5 Proper Storage and Delivery of Drug Products 45
Storage Conditions 46
Preparation of Unit Doses 48
Use of Pharmacy Inventory as Floor Stock 49
iv Contents
Chapter 6 Receiving Monetary Compensation for Goods
and Services 53
Methods of Payment for Pharmacy Services 53
Profit and Markup 55
Section II Inventory Control 57
Chapter 7 Stocking the Pharmacy 59
The Drug Formulary 59
Ordering and Receipt of Drug Products and Devices 60
Ordering Regular Drugs and Devices 61
Chapter 8 Maintenance of Drug Products 65
Maintenance of Drug Products in Inventory 65
Importance of Proper Storage of Drug Products
in Inventory 66
Handling Expired Medications and Drug Recalls 66
Drug “Recapture” 67
Chapter 9 Commercial Calculations 71
Cost and Markup 71
Section III Pharmaceutical Calculations 75
Chapter 10 Fractions, Decimals, and Algebra Review 77
Dividing a Whole: Using Fractions 78
Working with Decimals 80
Use of Algebra in Pharmaceutical Calculations 82
Rounding Numbers 82
Using Roman Numerals 83
Chapter 11 Systems of Measurement 85
Common Systems of Measurement 85
Ratios 89
Temperature Conversions 90
Chapter 12 Using Percentages and Ratios 93
Percentage as Parts Per 100 93
Using Alligation 95
Using Drug Concentrations Expressed as a Ratio 96
Chapter 13 Measuring Equipment 101
Liquid Measurement 102
Measuring Solids 105
Chapter 14 Conversion of Solid Dosage Forms 109
Converting Between Measurement Systems 111
Contents v
Chapter 15 Conversion of Liquid Dosage Forms 115
Converting Between Liquid and Solid Dosage Forms 115
Chapter 16 Pediatric Doses 123
Computation of Pediatric Doses—Differences from the
Adult Dose 123
Computation of Dose by Body Surface Area (BSA) 125
Young’s Rule and Clark’s Rule 126
Recommended Daily Doses (Safe Dose) 126
Chapter 17 Parenteral Dosages 131
Parenteral Dosage Forms 131
Calculation of Parenteral Doses 132
Chapter 18 Intravenous Calculations 137
Administering Intravenous Medication—The IV Drip 137
Chapter 19 Intravenous Admixtures 143
Infusing Medications Over Time—The IV Drip
and Admixture 143
Chapter 20 Calculation of Dose per Time 149
Calculating the Amount of Drug Infused per Time
(Dose per Time) 149
Chapter 21 Bulk Compounding 153
Compounding Drugs by Procedure 153
Chapter 22 Math Test with Solutions 159
Section IV Pharmacy Operations 169
Chapter 23 Safety in the Workplace 171
Occupational Health and Safety Administration
Regulations 171
Disposal of Hazardous Waste 172
Sanitation Management 173
Spills 173
Chapter 24 Using Computers in the Pharmacy 177
Use of Computers in Pharmacy Practice 178
The Components of a Computer 178
Chapter 25 Communications Within the Pharmacy 183
Role of the Technician in Communication 183
Role of the Pharmacist in Communication 184
vi Contents
Section V Pharmacology 187
Chapter 26 Drug Nomenclature 189
Introduction 189
Proprietary Drug Nomenclature 190
Drugs That Affect the Central Nervous System 191
Drugs That Affect the Cardiovascular System 197
Drugs That Increase Pulmonary Ventilation 203
Drugs Used to Relieve Allergies (Antihistamines) 204
Drugs That Affect the Gastrointestinal System 205
Drugs for Use in Parasitic Infections 206
Drugs That Affect the Endocrine System 206
Drugs That Affect the Reproductive System 207
Drugs Used for Infection 209
Chapter 27 The Pharmacology of Drug Interactions 217
Ways In Which Drugs Can Interact 217
Drug Toxicity and Interactions 219
Drugs That Affect the Autonomic Nervous System 222
Suggested Reading 226
Appendix A Look Alike and Sound Alike Drugs—
Avoiding a Fatal Error 227
Appendix B Pretest with Answers 231
Appendix C Sample Examination and Answer Sheet;
Answers for Scoring 249
Index 269
Preface
One of the most rapidly growing fields today is pharmaceutical thera-
peutics. This rapid growth has created opportunities for a variety of well-
trained technical personnel: physician’s assistants, medical assistants,
nursing assistants, and pharmacy assistants. In fact, one of the most rap-
idly expanding positions is that of the pharmacy assistant—now called,
in most states, the pharmacy technician.
The growing demand for these trained technical personnel is due, in
large part, to the rapidly expanding area of drug research and drug dis-
covery. The pharmacist simply does not have enough time to keep up
with recent advances in drug therapy and new dosage delivery systems,
and counseling patients and physicians, in addition to the other duties
such as drug dispensing, ordering, and the record keeping which is
required by law. This need for well-qualified technicians to perform
sophisticated duties has created the requirement for a standardized
examination to ensure that the technicians working within a pharmacy
uphold an acceptable level of knowledge and integrity. Thus, a national
examination for the certification of pharmacy technicians has been creat-
ed to replace state certification examinations. The Pharmacy Certification
Training Board (PCTB) administers this examination for certification of
pharmacy technicians (CPhT). The high standards and increasing diffi-
culty of this examination have created a need for a text which, in addition
to being useful for the student of pharmacy technology, will address the
main features of the examination, providing information, a comprehen-
sive review, and a basis for understanding the concepts addressed in the
examination. Delmar’s Pharmacy Technician Certification Exam Review was
written to fill this need. This text was designed for a twofold purpose: to
function as a review for technicians familiar with the material and to
serve as a learning tool both for students of pharmacy technology and for
technicians who have been trained to perform a limited number of duties
(such as within a retail pharmacy). These technicians must now become
familiar with broader concepts, such as pharmacology and advanced
pharmaceutical calculations, in order to become certified.
The text is written in conversational style, to facilitate understanding
of difficult concepts among many levels of readers. Foremost in the text
is an examination of the routine procedures in the pharmacy: accepting
viii Preface
prescriptions, creating patient profiles, processing and filling prescrip-
tions, and maintaining inventory. This portion of the text covers proce-
dures in both the retail and institutional pharmacy settings, and provides
comparisons between them. Special care has been taken to discuss not
only the procedures themselves but the reasoning behind the proce-
dures—why are they done in a particular way? This approach is not only
necessary to understand work within a pharmacy but is critical to doing
well on the certification examination.
Alarge block of chapters dealing with pharmaceutical calculations has
also been provided, which covers a large variety of types of calculations
that will appear on the examination. These have been presented in a sim-
ple, easy-to-understand manner, designed to take the fear out of math.
Topics include not only simple dosage conversions but intravenous calcu-
lations, pediatric dosages, compounding, and commercial calculations, as
well. All math problems are followed by a section containing the correct
answers and a detailed explanation of the reasoning and calculations lead-
ing to the correct answer. An entire chapter consisting only of math prob-
lems, with answers and worked-out solutions, is included as well.
Among the review material provided, the text contains a pretest,
which will assist the reader in prioritizing material to review and study.
Each chapter begins with a “Quick Study,” a concise summary outline of
the material within the chapter, which is designed to accommodate read-
ers at different levels of knowledge. In addition, each chapter contains
questions or problems to be worked out, with detailed solutions and
answers, which will help the reader understand the thought processes
that are crucial to understanding and correctly answering the questions
on the examination. Finally, a sample examination is included, with stan-
dardized answer sheets, such as those which will be used for the exami-
nation.
The author of Delmar’s Pharmacy Technician Certification Exam Review,
Dr. Patricia Anthony, is a practicing pharmacologist with advanced
degrees in biology and pharmacology, and bachelor’s degrees in biology
and pharmaceutical science. In addition, she holds a doctorate in phar-
macology from New York Medical College. Before devoting full time to
teaching and research, Dr. Anthony devoted full time to medical research
as postdoctoral faculty within Harvard Medical School in Massachusetts.
Acknowledgements
The author wishes to thank the reviewers, and especially thanks Mrs.
Judie Kautz and Mr. John Carbonaro for their efforts, which made the
production of this text possible.
Introduction
About the PCTB Examination
Structure of the Examination
The PCTB examination consists of 125 multiple choice questions. It is a
timed test, which lasts for three hours. This means that you must pace
yourself in answering the questions. There are three general areas in
which competency will be assessed:
1. Assisting the pharmacist in serving patients.
This portion includes interpretation of the prescription order; con-
struction and use of the patient profile; and dispensing, labeling, stor-
age, and delivery of medications. Also included are pharmaceutical
calculations: dosage conversions, intravenous medications, IV admix-
tures, dose per time, and commercial calculations. These questions
will make up 50% of the exam (about 60–70 questions). Both hospital
and retail settings will be covered, and the student will be expected to
know the differences in procedures between the different settings.
The questions will require you to think about why you are doing
things a certain way as well (with responsibility comes challenge). For
example, why is certain information required on the prescription
order and profile? Why do we have the patient profile? Why do we
use aseptic technique when preparing intravenous medications? This
book will train you to think about these things as you answer the
questions.
2. Medication distribution and inventory control.
This portion addresses how the medication is stored in the pharmacy,
the ordering and inventory process, prepackaging and unit dose dis-
tribution, labeling, and record-keeping. These questions will make up
35% of the exam (40–50 questions).