Free ExCPT Exam Flashcards

Controlled substances with high abuse potential but accepted medical use. Includes oxycodone, morphine, fentanyl, methylphenidate, and amphetamines. No refills allowed; new prescription required each time. Must be stored in a locked cabinet.

Controlled substances with moderate abuse potential and accepted medical use. Includes codeine combinations, ketamine, anabolic steroids, and buprenorphine. May be refilled up to 5 times within 6 months of issue date.

Controlled substances with low abuse potential relative to Schedule III. Includes benzodiazepines (alprazolam, diazepam), zolpidem, tramadol, and phenobarbital. May be refilled up to 5 times within 6 months of issue date.

The single-sheet order form required for ordering Schedule I and II controlled substances (triplicate forms have not been used since October 30, 2021). Must be signed by an authorized DEA registrant or power of attorney. The purchaser keeps a copy and sends the original to the supplier. Also available electronically (CSOS).

Schedule III-V prescription information may be transferred one time between pharmacies for refills; pharmacies sharing a real-time online database may transfer up to the maximum refills allowed. An unfilled electronic Schedule II-V prescription may be transferred once between retail pharmacies for initial dispensing. Transfers are pharmacist to pharmacist, with both pharmacists' names and the receiving pharmacy's DEA number recorded.

Health Insurance Portability and Accountability Act protects patients' protected health information (PHI). Technicians must keep PHI confidential and limit its use and disclosure to the minimum necessary.

The date after which a compounded preparation should not be used. Different from manufacturer's expiration date. For non-sterile compounding without stability data (USP <795>, 2022): nonpreserved aqueous forms 14 days refrigerated; preserved aqueous forms 35 days; nonaqueous oral liquids 90 days; other nonaqueous forms 180 days.

Dispense As Written codes indicate substitution instructions. DAW 0: no product selection indicated; DAW 1: substitution not allowed by prescriber; DAW 2: patient requested brand; DAW 3-9: various pharmacy/payer-specific codes.

Abbreviations for prescription directions. Common examples: PO (by mouth), QD (daily), BID (twice daily), TID (three times daily), PRN (as needed), HS (at bedtime), AC (before meals), PC (after meals), UD (as directed).

National Drug Code - FDA's unique 10-digit, 3-segment identifier for drug products, in a 4-4-2, 5-3-2 or 5-4-1 configuration: labeler code, product code (strength, dosage form, formulation) and package code. Billing systems often pad it to the 11-digit HIPAA format with a leading zero.

A method using uppercase letters to differentiate look-alike drug names and prevent medication errors. Examples: hydrOXYzine vs hydrALAzine, predniSONE vs prednisoLONE, DOPamine vs DOBUTamine.

Warning or instruction labels applied to prescription containers. Examples: 'Take with food,' 'May cause drowsiness,' 'Avoid alcohol,' 'Shake well,' 'Refrigerate.' Selection based on drug properties and patient safety requirements.

The pharmacist must verify all prescriptions before dispensing. Technicians perform data entry and filling but cannot verify. Triple-check process: receiving prescription, filling prescription, and final verification by pharmacist.

Antihypertensive medications ending in '-pril' (lisinopril, enalapril, ramipril). Work by inhibiting angiotensin-converting enzyme. Common side effect: dry cough. Contraindicated in pregnancy. May cause hyperkalemia.

Cardiovascular medications ending in '-olol' (metoprolol, atenolol, propranolol). Reduce heart rate and blood pressure. Used for hypertension, angina, arrhythmias, and heart failure. May mask hypoglycemia symptoms in diabetics.

Cholesterol-lowering medications ending in '-statin' (atorvastatin, simvastatin, rosuvastatin). Work by inhibiting HMG-CoA reductase. Side effects include muscle pain (myalgia) and elevated liver enzymes.

Gastric acid suppressants ending in '-prazole' (omeprazole, pantoprazole, esomeprazole). Work by irreversibly blocking hydrogen-potassium ATPase. Used for GERD, peptic ulcers, and H. pylori treatment. Take 30-60 minutes before meals.

Selective Serotonin Reuptake Inhibitors used for depression and anxiety. Examples: fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro). Black box warning for suicidal thoughts in young patients. Takes 4-6 weeks for full effect.

Broad-spectrum antibiotics ending in '-floxacin' (ciprofloxacin, levofloxacin, moxifloxacin). Black box warnings for tendon rupture, peripheral neuropathy, and CNS effects. Avoid with dairy products and antacids (chelation).

Expressed as grams per 100 mL (w/v), grams per 100 g (w/w), or mL per 100 mL (v/v). Example: 2% solution = 2g/100mL. To calculate amount: (percent/100) × total volume = grams of drug needed.

Expresses concentration as 1:X (1 part drug to X parts total). Example: 1:1000 = 1g per 1000mL = 0.1%. To convert ratio to percent: (1/ratio denominator) × 100. Used commonly for epinephrine concentrations.

C₁V₁ = C₂V₂ where C is concentration and V is volume. Used to determine how to dilute stock solutions. Example: To make 500mL of 1:10 dilution from concentrate, use 50mL concentrate plus 450mL diluent.

A calculation method for mixing two different concentrations to achieve a desired intermediate concentration. Create an X pattern: higher concentration minus desired equals parts of lower; desired minus lower equals parts of higher.

Total quantity dispensed divided by daily dose. Example: #90 tablets, take 1 tablet TID = 90/3 = 30 days supply. For 'PRN' medications, calculate based on maximum allowed daily dose as stated in sig.

Calculate dose using mg/kg/day then divide by dosing frequency. Example: Child weighs 20kg, dose is 10mg/kg/day divided BID = 200mg/day ÷ 2 = 100mg per dose. Always verify calculated dose is within safe range.

When one drug affects the activity of another. Pharmacokinetic interactions affect ADME (absorption, distribution, metabolism, excretion). Pharmacodynamic interactions affect drug action at the receptor. Technicians must alert pharmacists to potential interactions.

The ratio of toxic dose to therapeutic dose (TD50/ED50). Drugs with narrow therapeutic index (warfarin, digoxin, lithium, phenytoin) require careful monitoring because the difference between effective and toxic doses is small.

Drug metabolism that occurs in the liver before reaching systemic circulation, reducing bioavailability of orally administered drugs. Drugs with high first-pass effect may require higher oral doses or alternative routes (sublingual, transdermal).

The time required for drug concentration to decrease by 50%. Determines dosing frequency. Steady state is reached after 4-5 half-lives. Drugs with longer half-lives require less frequent dosing but take longer to clear from the body.

A larger initial dose given to rapidly achieve therapeutic drug levels, typically when immediate effect is needed or the drug has a long half-life. Example: loading dose of digoxin, warfarin, or certain antibiotics.

A clean room classification with no more than 3,520 particles ≥0.5 microns per cubic meter. Required for compounding sterile preparations. Achieved through HEPA-filtered laminar airflow hoods (LAFHs) within ISO Class 7 buffer rooms.

Provides ISO Class 5 environment using HEPA-filtered unidirectional airflow. Horizontal flow hoods blow air toward the operator; vertical flow hoods blow air downward. Sterile hazardous drugs need a containment PEC such as a BSC or CACI (USP <800>). Apply sterile 70% IPA to the work surface immediately before compounding and at least every 30 minutes (USP <797>).

Practices to maintain sterility during compounding: proper hand hygiene, garbing procedures, work within direct compounding area, avoid shadowing, never touch critical sites, disinfect all surfaces and vial tops with 70% isopropyl alcohol.

The United States Pharmacopeia chapter governing sterile compounding. Establishes standards for personnel training, facility design, environmental monitoring, and beyond-use dating. The 2022 revision replaced the low-, medium- and high-risk levels with Category 1, 2 and 3 CSPs, set mainly by the conditions where they are made and how long they may be used.

Intravenous nutrition providing all necessary nutrients: dextrose (carbs), amino acids (protein), lipids (fat), electrolytes, vitamins, and minerals. Requires strict aseptic technique due to high contamination risk. Its BUD follows the USP <797> category it is compounded under.

USP 800 establishes standards for handling hazardous drugs (chemotherapy, hormones, antivirals). Sterile HD compounding uses a C-PEC (BSC or CACI) in a negative-pressure, externally vented room, and compounders wear gowns, head, hair and shoe covers and two pairs of chemotherapy gloves. Spill kits must be readily available.

A real-time inventory tracking system that continuously updates stock levels with each transaction. Federal DEA rules require initial and biennial controlled-substance inventories rather than a perpetual one, but state rules or employer policy may require one for Schedule II drugs. Running balances are reconciled periodically with physical counts.

Periodic Automatic Replenishment level - the minimum and maximum quantities of inventory to maintain. When stock drops to minimum (reorder point), order enough to reach maximum. Based on usage patterns and lead time.

FDA recall classifications: Class I - serious health consequences or death possible (immediate removal); Class II - temporary or reversible health problems; Class III - unlikely to cause adverse health consequences. Pharmacy must document recall actions.

Expired medications must be removed from active inventory, quarantined, and properly disposed of or returned. Check expiration dates monthly. FIFO (First In, First Out) rotation minimizes waste. Document all expired medication disposals.

A list of medications approved for use within a healthcare system or covered by an insurance plan. May be open (any drug), closed (only listed drugs), or restricted (prior authorization required). Generic substitution policies are typically defined.

Medications with similar names or appearances that can be confused. Examples: metFORMIN/metroNIDAZOLE, HumaLOG/HumuLIN, Celebrex/Celexa. Prevention strategies include tall man lettering, shelf separation, and barcode verification.

Drugs that carry heightened risk of significant patient harm if used in error. Categories include anticoagulants, insulin, opioids, chemotherapy, and concentrated electrolytes. Require independent double-checks and special handling procedures.

Strategies include barcode scanning, tall man lettering, patient counseling by pharmacist, triple-check procedures, avoiding dangerous abbreviations (U, IU, QD, QOD), and reporting errors through quality improvement systems.

Two patient identifiers must be used before dispensing medications. Acceptable identifiers include full name, date of birth, address, phone number, or medical record number. Room number alone is not acceptable as an identifier.

Schedule II-V substances must be destroyed in a manner that renders them non-retrievable. Options include DEA-authorized reverse distributors, take-back events, or witnessed destruction with documentation. Two-person witness required for in-pharmacy destruction.

A complete inventory of all controlled substances required every two years by DEA regulations. Must include an exact count for Schedule II; for Schedules III-V, an open container may be estimated unless it holds more than 1,000 tablets or capsules. Date, time, and signature of responsible person required.

Calculate drops/minute: (Volume in mL × Drop factor) ÷ Time in minutes. Drop factors vary by tubing: microdrip = 60 gtt/mL, macrodrip = 10, 15, or 20 gtt/mL. Or for mL/hour: Volume (mL) ÷ Time (hours).

The process of adding diluent to a powder medication to create a liquid form. Follow manufacturer instructions for diluent type and volume. Note new concentration after reconstitution and assign appropriate beyond-use date.

Red flags include: alterations or erasures, quantities spelled differently than written numerically, unusual quantities, multiple controlled substances, patient traveling unusual distance, prescriber DEA number invalid, and unknown prescriber. Report concerns to pharmacist.