PTCE flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Levothyroxine administration

Synthetic T4 used for hypothyroidism; it is taken on an empty stomach 30 to 60 minutes before breakfast and separated from calcium, iron, and antacids by at least four hours.

Metformin lactic acidosis risk

Biguanide antidiabetic with a boxed warning for lactic acidosis; hold before iodinated contrast procedures when eGFR is 30 to 60 mL/min/1.73 m2 and during acute illness.

Warfarin monitoring and reversal

Vitamin K antagonist anticoagulant monitored with the INR; phytonadione (vitamin K) reverses its effect, and many drugs plus vitamin K-rich foods alter the INR.

Vancomycin adverse effects

Glycopeptide antibiotic that is nephrotoxic and ototoxic; infusing too rapidly causes histamine-mediated flushing called red man syndrome, and trough levels guide dosing for serious infections.

Insulin storage requirements

Unopened insulin vials and pens are refrigerated at 2 to 8 degrees Celsius and never frozen; in-use pens stay at room temperature and are discarded per the manufacturer's labeled number of days.

Methotrexate weekly dosing hazard

For rheumatoid arthritis and psoriasis, methotrexate is given once weekly; daily dosing causes fatal bone marrow suppression, and folic acid or leucovorin reduces toxicity.

ACE inhibitor adverse effects

Cough, hyperkalemia, and angioedema are characteristic of angiotensin-converting enzyme inhibitors, which are contraindicated during pregnancy and require monitoring of potassium and renal function.

Therapeutic equivalence AB rating

In the FDA Orange Book, an AB rating means two products are therapeutically equivalent and may be substituted because they are pharmaceutically equivalent and bioequivalent.

Amiodarone monitoring parameters

Class III antiarrhythmic that accumulates in tissue and can cause thyroid dysfunction, pulmonary fibrosis, corneal microdeposits, and hepatotoxicity, so baseline and periodic thyroid, liver, and pulmonary monitoring is required.

Schedule II refill rule

Schedule II prescriptions cannot be refilled; a prescriber must issue a new prescription for each fill, and partial fills are permitted only under specific exceptions such as long-term care.

Schedule III-V refill limits

These prescriptions may be refilled up to five times within six months of the date the prescription was issued; after five refills or six months, a new prescription is required.

DEA Form 222

The order form required to purchase Schedule I and II controlled substances; it must be completed accurately, and electronic ordering through CSOS is now permitted.

DEA Form 106

Used to report the theft or significant loss of controlled substances to the DEA field division; the pharmacy must also notify local authorities as required.

Pseudoephedrine sales limits

Under the Combat Methamphetamine Epidemic Act, a purchaser may buy no more than 3.6 grams of ephedrine or pseudoephedrine per day and 9 grams in any 30-day period.

Poison Prevention Packaging Act

Requires child-resistant packaging for most oral prescription drugs unless the prescriber specifies otherwise or the patient requests non-child-resistant containers in writing or verbally.

DSCSA product identifier

A unique code on each package containing the NDC, serial number, lot number, and expiration date; pharmacies must verify suspect products and keep transaction records for six years.

Biennial controlled substance inventory

Federal law requires an inventory every two years; Schedule II counts must be exact, while Schedule III through V may be estimated unless a container holds 1000 or more units.

Do not use abbreviations

ISMP and The Joint Commission prohibit U for units, QD and QOD, MS for morphine sulfate, naked decimals such as .5 mg, and trailing zeros such as 5.0 mg.

Tall man lettering

Mixed-case capitalization highlights differing letters in look-alike drug names, such as hydrOXYzine versus hydrALAZINE and glipiZIDE versus glyBURIDE, reducing selection errors.

USP 797 buffer area

The room where sterile compounding occurs must meet ISO Class 7 at rest and in operation and must house an ISO Class 5 primary engineering control such as a laminar airflow workbench.

USP 800 hazardous drug handling

Requires containment strategies for hazardous drugs, including closed-system transfer devices, two pairs of chemotherapy gloves, gowns, and a NIOSH-certified respirator when handling spills.

Refrigerator temperature range

Pharmaceutical refrigerators are maintained at 2 to 8 degrees Celsius (36 to 46 Fahrenheit) with continuous monitoring and documented readings; freezing damages most vaccines and insulin.

High-alert medication double check

Drugs with a heightened risk of harm, such as insulin, heparin, opioids, and concentrated electrolytes, require independent double checks and separate storage to prevent catastrophic errors.

Hazardous drug spill kit

Contains absorbent pads, chemotherapy gloves, gowns, shoe covers, eye protection, and waste bags; spills are cleaned from the outside inward and disposed of as trace hazardous waste.

Sentinel event root cause analysis

An unexpected occurrence involving death or serious harm triggers a root cause analysis, which The Joint Commission expects to be completed within 45 calendar days of the event.

Days supply formula

Divide the total quantity dispensed by the quantity used per day; for example, 90 tablets taken three times daily equals a 30-day supply.

C1V1 dilution equation

The concentration of a stock solution multiplied by its volume equals the final concentration multiplied by the final volume, allowing calculation of diluent needed to reach a target strength.

Percent weight-volume strength

Percent weight-volume expresses grams of solute per 100 mL of solution; a 1:1000 ratio strength equals 0.1 percent weight-volume or 1 mg per mL.

Cockcroft-Gault creatinine clearance

Estimated creatinine clearance equals (140 minus age) times weight in kilograms, divided by 72 times serum creatinine, and multiplied by 0.85 for female patients.

DEA number verification

Add the first, third, and fifth digits to twice the sum of the second, fourth, and sixth digits; the last digit of that total matches the final DEA number digit.

IV drip rate formula

Drops per minute equal the volume in milliliters multiplied by the drop factor in drops per milliliter, divided by the infusion time in minutes.

Mosteller body surface area

Body surface area in square meters equals the square root of height in centimeters times weight in kilograms divided by 3600.