Mixed Deck — All ExCPT Test Topics Flashcards

Which of the following medications is a controlled substance due to its potential for abuse and dependence, requiring specific handling and record-keeping procedures?

Answer: Alprazolam

Alprazolam (brand name Xanax) is a benzodiazepine classified as a Schedule IV controlled substance by the DEA. It has a potential for abuse and dependence, necessitating stricter regulations for prescribing, dispensing, and inventory management compared to non-controlled drugs like metformin, atorvastatin, and amlodipine.

When compounding a sterile preparation, which of the following actions is performed first in the garbing process before entering the cleanroom's buffer area?

Answer: Putting on a hair cover and face mask

The correct garbing sequence, from dirtiest to cleanest, requires applying shoe covers, then a hair cover, beard cover (if applicable), and a face mask before proceeding to hand hygiene and donning a gown. This minimizes contamination of cleaner items.

Which federal law first required the child-resistant packaging for most OTC and prescription medications?

Answer: Poison Prevention Packaging Act of 1970

The Poison Prevention Packaging Act (PPPA) of 1970 required child-resistant packaging for most prescription and OTC drugs to reduce accidental pediatric poisonings.

A prescription for a controlled substance has been called in as a verbal order for a non-emergency situation. What must the pharmacist do?

Answer: Refuse to fill it — only Schedule III-V can be accepted verbally, and only in non-emergency situations

Schedule III-V controlled substances may be accepted verbally in non-emergency situations. Schedule II requires a written (or emergency oral, with written follow-up) order. The pharmacist should fill it promptly and maintain documentation.

To prevent a medication error involving the wrong drug being dispensed, which of the following is a critical step in the prescription filling process?

Answer: Verifying the prescription by matching the National Drug Code (NDC) on the stock bottle to the NDC in the pharmacy computer system.

Using the National Drug Code (NDC) is a precise method to verify that the medication being dispensed is the exact product (manufacturer, drug, and package size) specified in the prescription order. This is a key safety check to prevent wrong drug errors. While correct patient information is vital, and high-alert stickers are useful for specific drugs, the NDC check is a fundamental verification step for all prescriptions.

A prescription is written for 'Celebrex 200 mg.' The technician dispenses Celexa 200 mg instead. What type of error is this?

Answer: Wrong drug error

Dispensing Celexa (citalopram, an antidepressant) instead of Celebrex (celecoxib, an NSAID) is a wrong drug error — a classic look-alike/sound-alike (LASA) mix-up.

Which government agency is primarily responsible for licensing pharmacists, registering pharmacy technicians, and disciplining licensees for misconduct within a specific state?

Answer: State Board of Pharmacy

The State Board of Pharmacy is the regulatory body responsible for establishing and enforcing pharmacy laws and regulations at the state level. This includes licensing pharmacists and pharmacies, registering technicians, and taking disciplinary action against those who violate the state's Pharmacy Practice Act. The FDA regulates drug manufacturing and approval, while the DEA enforces controlled substance laws.

Which system is widely used to classify medication errors by severity?

Answer: NCC MERP index

The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index categorizes errors from Category A (no error, circumstances) to Category I (error contributing to patient death).

A patient brings in a prescription for a brand-name drug. The pharmacy has the generic equivalent in stock. The prescriber has not indicated 'DAW' or 'brand only.' What should the pharmacy do?

Answer: Dispense the generic equivalent unless the patient or prescriber specifically requests the brand

Without a DAW or brand-only indication, most states permit (and many insurance plans require) generic substitution of an FDA-approved equivalent.

What does the term 'clean room' refer to in a sterile compounding pharmacy?

Answer: An environmentally controlled space with defined ISO air quality classifications for sterile preparation

A clean room is an ISO-classified, environmentally controlled space designed to minimize airborne particulates and microbial contamination during sterile compounding.

Which of the following medications must be stored in the refrigerator (2–8°C)?

Answer: Insulin glargine (unopened)

Unopened insulin glargine must be refrigerated at 2–8°C to maintain potency.

Under HIPAA, which of the following is considered Protected Health Information (PHI)?

Answer: A patient's diagnosis combined with their name and date of birth

PHI is individually identifiable health information that includes any data element (name, date, condition, etc.) that could be used to identify a specific person's health status.

Why is it important to use a second patient identifier in addition to the patient’s name?

Answer: To prevent confusion between patients with similar names.

Using a second patient identifier, such as date of birth or address, is a crucial safety measure to confirm the correct patient. This practice helps prevent medication errors that could arise from confusing patients with identical or similar names. It ensures the right medication is dispensed to the right person, which is a fundamental principle of patient safety.

Which of the following best describes the difference between a manufacturer's expiration date and a compound's beyond-use date (BUD)?

Answer: The expiration date is determined by the drug manufacturer based on stability testing, while the BUD is assigned by the pharmacy for a specific compounded preparation.

A manufacturer's expiration date is based on extensive stability testing of a specific, sealed commercial product. A beyond-use date (BUD) is assigned to a compounded preparation by the pharmacy and is determined by factors like the date of compounding, ingredients used, and USP guidelines to ensure safety and potency for a custom-made product.

Which agency regulates the disposal of pharmaceutical hazardous waste in the United States?

Answer: EPA

The Environmental Protection Agency (EPA) regulates pharmaceutical hazardous waste disposal under RCRA regulations.

Which inventory method is most commonly used in pharmacies to ensure medications are rotated properly?

Answer: First In, First Out (FIFO)

The First In, First Out (FIFO) inventory method ensures that the oldest inventory (those received first) is used or dispensed before newer inventory. This is crucial in pharmacies to prevent medications from expiring on the shelves, minimizing waste and ensuring patients receive drugs with adequate shelf life. It is a standard and essential practice for proper medication rotation and inventory management.

What is the maximum number of refills allowed for a Schedule III or IV controlled substance?

Answer: 5 refills within 6 months

Schedule III and IV controlled substances may be refilled up to 5 times within 6 months of the original date of issue.

Order reports are checked to make sure there are no problems in the order...

Answer: Manually

While many aspects of pharmacy operations are automated, order reports, especially for controlled substances or high-value items, are often checked manually. This manual verification ensures accuracy, identifies discrepancies, and helps prevent errors or theft that automated systems might miss. It provides a crucial layer of human oversight for critical processes.

What is the primary purpose of using a filter needle when withdrawing medication from a glass ampule?

Answer: To prevent glass particles from being introduced into the final preparation

When a glass ampule is broken, microscopic glass shards can fall into the solution. A filter needle is specifically designed to trap these particles as the medication is withdrawn, ensuring the final sterile product is free from glass contamination.

A pharmacy technician receives a prescription for warfarin. When filling this prescription, the technician should be aware of a significant drug-drug interaction with which of the following over-the-counter medications?

Answer: Ibuprofen

Ibuprofen is a Nonsteroidal Anti-Inflammatory Drug (NSAID) that can increase the risk of bleeding when taken with warfarin, an anticoagulant. This is a clinically significant interaction that pharmacy staff should recognize. Acetaminophen is a safer choice for pain relief for patients on warfarin.