Roles + Scope
15%of exam
Laws + Regulations
15%of exam
Drugs + Therapy
13%of exam
Dispensing Process
43%of exam
Safety + Quality
14%of exam
Quick Facts
- Exam
- ExCPT
- Credential
- CPhT
- Scored
- 100 items
- Pretest
- 20 items
- Time
- 2h 10m
- Pass
- 390/500
- Provider
- NHA
- Renewal
- 2 years
Role Scope
- Technician
- Assists pharmacist
- Pharmacist
- Final clinical judgment
- Counseling
- Pharmacist duty
- Data entry
- Technician task
- Refills
- Process per law
- HIPAA
- Protect PHI
- Professionalism
- Ethical conduct
Schedule Memory
I no use; II no refills.
I: no useII: no refillsIII-V: limitedDEA: verify
C-II vs C-III-V
C-II
- No refills
- Highest legal risk
C-III-V
- Limited refills
- Lower abuse schedule
No refills vs limited
Laws Schedules
- CSA
- Controlled substances
- Schedule I
- No accepted use
- Schedule II
- High abuse
- Schedule III
- Moderate abuse
- Schedule IV
- Lower abuse
- Schedule V
- Lowest abuse
- DEA number
- Prescriber identifier
Federal Acts
- FDCA
- Drug safety framework
- Durham-Humphrey
- Rx/OTC split
- Kefauver-Harris
- Efficacy required
- OBRA-90
- Counseling offer
- HIPAA
- Privacy/security
- DSCSA
- Drug tracing
- REMS
- Risk controls
Brand vs Generic
Brand
- Trade name
- Manufacturer marketed
Generic
- Nonproprietary name
- Same active ingredient
Trade vs ingredient
Drug Names
- Generic
- Nonproprietary name
- Brand
- Trade name
- NDC
- Drug package code
- Strength
- Amount per unit
- Dosage form
- Tablet/liquid/etc
- Route
- How administered
- Therapeutic class
- Clinical use group
Solution vs Suspension
Solution
- Drug dissolved
- Uniform liquid
Suspension
- Particles dispersed
- Shake well
Dissolved vs dispersed
Common Classes
- ACE inhibitors
- Lower blood pressure
- Beta blockers
- Slow heart rate
- Statins
- Lower cholesterol
- Anticoagulants
- Prevent clots
- NSAIDs
- Pain/inflammation
- Antibiotics
- Treat bacteria
- Insulins
- Lower glucose
Rx Elements
Patient, prescriber, drug, SIG, quantity.
PatientPrescriberDrugDirectionsQuantity
DAW vs Substitution
DAW
- Dispense as written
- Prescriber/patient code
Substitution
- Generic allowed
- State law controls
Block vs allow
Dispensing Picker
- Prescription incomplete→Clarify prescriber
- Controlled substance→Verify DEA
- Substitution requested→Check DAW
- Insurance rejects→Resolve claim
- Interaction alert→Refer pharmacist
- Counseling requested→Refer pharmacist
Prescription Intake
- Patient
- Name and DOB
- Prescriber
- Authorized provider
- Drug
- Name/strength/form
- SIG
- Directions
- Quantity
- Amount dispensed
- Refills
- Authorized repeats
- DAW
- Substitution instruction
- Validity
- Complete and legal
Claim Codes
BIN routes; PCN narrows.
BIN: processorPCN: routingID: memberGroup: plan
PA vs Formulary
PA
- Approval needed
- Clinical review
Formulary
- Covered list
- Tier rules
Permission vs list
Math Picker
- Units differ→Convert first
- Dose by weight→mg/kg
- Liquid quantity→mL calculation
- Mixture strengths→Alligation
- Days requested→Day supply
- Percent strength→Parts per hundred
Pharmacy Math
- Ratio
- Compare quantities
- Proportion
- Solve equivalent ratios
- Percent
- Parts per hundred
- mg
- Milligram
- mL
- Milliliter
- Day supply
- Quantity divided use
- Alligation
- Mix strengths
- BSA
- Body surface area
Sterile vs Nonsterile
Sterile
- No microorganisms
- USP 797
Nonsterile
- Topical/oral forms
- USP 795
Aseptic vs routine
Compounding
- USP 795
- Nonsterile compounding
- USP 797
- Sterile compounding
- USP 800
- Hazardous drugs
- Aseptic
- Prevent contamination
- Beyond-use
- Compounded dating
- Reconstitution
- Add diluent
- Unit dose
- Single administration
Billing
- BIN
- Processor identifier
- PCN
- Routing code
- Group
- Plan group
- Member ID
- Patient plan ID
- PA
- Prior authorization
- Formulary
- Covered drug list
- COB
- Coordinate benefits
Safety Flow
Check, label, verify, document.
Check stockLabel warningsRefer alertsRecord actions
Safety Picker
- Look-alike names→Tall man
- Expired stock→Quarantine
- Recall notice→Remove stock
- Cold item arrives→Check temperature
- Hazardous drug→USP 800
- Abbreviation unsafe→Clarify order
Inventory Safety
- FIFO
- First in first out
- FEFO
- Earliest expiration first
- Recall
- Remove affected drug
- Quarantine
- Separate unusable stock
- Cold chain
- Temperature controlled
- Tall man
- Look-alike warning
- ISMP
- Safety abbreviation list
Labels Alerts
- Aux label
- Use warning
- Med Guide
- Required patient info
- Allergy alert
- Potential reaction
- Interaction
- Drug conflict
- Duplicate therapy
- Same class overlap
- High-alert drug
- Severe harm risk
- Expiration
- Do not dispense
Common Traps
Counseling duty
Technician offers help ≠ Pharmacist counsels patient
C-II refills
C-II has no refills ≠ Partial fills follow law
mL vs mg
mL measures volume ≠ mg measures weight
DAW codes
DAW blocks substitution ≠ Blank permits substitution
Expiration vs BUD
Expiration is manufacturer ≠ BUD is compounded
PA vs rejection
PA needs approval ≠ Rejection needs resolution
Last Minute
- 1.100 scored; 20 pretest
- 2.2h 10m total time
- 3.390 scaled score passes
- 4.Dispensing = largest domain
- 5.C-II = no refills
- 6.DAW controls substitution
- 7.BIN/PCN route claims
- 8.USP 797 = sterile
- 9.USP 800 = hazardous
- 10.Pharmacist counsels patients
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