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Which of the following is classified as a narrow therapeutic index (NTI) medication that requires extra caution during sterile compounding?

Amoxicillin

Gentamicin

Metronidazole

Azithromycin

to track

2026 Statistics

Key Facts: CSPT Exam

Total Questions

60 scored + 15 unscored

1,400

Passing Score

Scaled (1,000-1,600)

1h 50m

Exam Duration

PTCB

$199

Exam Fee

PTCB ($50 app + $149 exam)

53%

Compounding Procedures

Largest domain

Annual

Recertification

10 CE hours + attestation

The CSPT exam has 75 questions (60 scored + 15 unscored) in 1 hour 50 minutes with a passing score of 1,400 (scaled, 1,000-1,600 range). Four domains: Sterile Compounding Procedures (53%), Facilities and Equipment (22%), Medications and Components (17%), and Handling/Packaging/Storage/Disposal (8%). Requires active PTCB CPhT plus sterile compounding education or 3 years CSP experience. Annual recertification required.

Sample CSPT Practice Questions

Try these sample questions to test your CSPT exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Which of the following is classified as a narrow therapeutic index (NTI) medication that requires extra caution during sterile compounding?

A.Amoxicillin

B.Gentamicin

C.Metronidazole

D.Azithromycin

Explanation: Gentamicin is an aminoglycoside antibiotic with a narrow therapeutic index (NTI), meaning small differences in dose or blood concentration can lead to serious therapeutic failures or adverse drug reactions. NTI medications require special handling, precise calculations, and often independent verification during compounding. Amoxicillin, metronidazole, and azithromycin have wider therapeutic windows.

2A pharmacy technician is preparing a concentrated potassium chloride injection. What type of medication is this considered?

A.Controlled substance

B.High-alert medication

C.Investigational drug

D.Over-the-counter equivalent

Explanation: Concentrated electrolytes like potassium chloride are classified as high-alert medications because errors in their preparation or administration can cause significant patient harm, including cardiac arrest. High-alert medications require special safeguards including independent double-checks, clear labeling, and often storage in separate areas to prevent accidental misuse.

3Which chemotherapy agent requires special handling as a hazardous drug during sterile compounding?

A.Methotrexate

B.Fluorouracil

C.Both A and B

D.Neither A nor B

Explanation: Both methotrexate and fluorouracil are antineoplastic agents classified as hazardous drugs. They require special handling including preparation in a biological safety cabinet (BSC) or compounding aseptic containment isolator (CACI), use of personal protective equipment (PPE), and specific disposal procedures. Technicians must follow USP <800> guidelines when handling these medications.

4Insulin is considered a high-alert medication primarily because:

A.It requires refrigeration at all times

B.It has a narrow therapeutic index and dosing errors can cause severe hypoglycemia or hyperglycemia

C.It is always compounded from bulk powder

D.It is classified as a controlled substance by the DEA

Explanation: Insulin is a high-alert medication due to its narrow therapeutic index. Small errors in dosing (such as confusing units with milliliters) can lead to severe hypoglycemia, coma, or death. While insulin does require proper storage, the primary safety concern is the potential for serious patient harm from dosing errors.

5Which of the following anticoagulants is considered a high-alert medication requiring special compounding precautions?

A.Warfarin

B.Heparin

C.Aspirin

D.Clopidogrel

Explanation: Heparin is a high-alert anticoagulant that requires special precautions during compounding. Errors in heparin dosing or concentration can lead to serious bleeding or thrombotic events. Heparin injections must be prepared with careful attention to units, concentrations, and labeling to prevent medication errors.

6What is the maximum beyond-use date (BUD) for a low-risk sterile compounded preparation stored at controlled room temperature?

A.24 hours

B.48 hours

C.4 days

D.14 days

Explanation: According to USP <797>, low-risk compounded sterile preparations (CSPs) with proper aseptic technique and sterilization methods may be assigned a beyond-use date of up to 48 hours at controlled room temperature (20-25°C). This assumes all components are sterile and the preparation meets low-risk criteria.

7Which factor does NOT typically influence the assignment of a beyond-use date for a compounded sterile preparation?

A.The chemical stability of the active ingredient

B.The storage temperature

C.The cost of the ingredients

D.The type of container-closure system

Explanation: Beyond-use dates are determined by scientific factors including chemical stability, microbial risk, storage conditions, and container compatibility. Cost is never a factor in determining BUDs. BUDs ensure patient safety by limiting the time a preparation can be stored before use.

8A compounded sterile preparation made under medium-risk conditions can be stored for a maximum of how long under refrigeration?

A.4 hours

B.24 hours

C.30 hours

D.9 days

Explanation: Medium-risk compounded sterile preparations (CSPs) prepared under proper aseptic conditions may be assigned a beyond-use date of up to 9 days when stored under refrigeration (2-8°C). This is significantly longer than room temperature storage (30 hours) due to the reduced microbial growth at cold temperatures.

9Light-sensitive medications should be stored:

A.In clear glass vials for easy identification

B.In amber or opaque containers to protect from photodegradation

C.Under direct fluorescent lighting

D.In open containers to prevent heat buildup

Explanation: Light-sensitive drugs can undergo photodegradation, which may reduce potency or create harmful degradation products. These medications should be stored in amber (brown) glass, opaque containers, or wrapped in light-protective coverings to minimize light exposure during storage and administration.

10Which of the following is the most important factor when determining the beyond-use date for a high-risk compounded sterile preparation?

A.The manufacturer's expiration date on the drug container

B.The chemical stability data and the microbial contamination risk

C.The day of the week the preparation was made

D.The preference of the prescribing physician

Explanation: High-risk CSPs involve non-sterile components or complex compounding processes, increasing both chemical stability concerns and microbial contamination risk. The BUD must account for both factors. High-risk CSPs have the shortest BUDs: 24 hours at room temperature, 3 days refrigerated, or 45 days frozen.

About the CSPT Exam

The CSPT (Certified Compounded Sterile Preparation Technician) exam validates advanced competency in sterile compounding procedures, facilities and equipment management, medication knowledge, and handling/packaging/storage/disposal of compounded sterile preparations. Requires active PTCB CPhT credential.

Questions

75 scored questions

Time Limit

1 hour 50 minutes

Passing Score

1,400 (scaled, 1,000-1,600 range)

Exam Fee

$199 (PTCB (Pharmacy Technician Certification Board) / Pearson VUE)

CSPT Exam Content Outline

53%

Sterile Compounding Procedures

Aseptic technique, garbing/PPE, hand hygiene, cleaning/disinfecting, hazardous drug compounding, parenteral nutrition, pharmacy calculations, media fill testing

22%

Facilities and Equipment

Primary engineering controls (LAFW, BSC, CAI), secondary engineering controls, ISO classification, HEPA filtration, environmental monitoring

17%

Medications and Components

Drug names/classifications, high-alert/NTI medications, stability factors, beyond-use dating (BUD), compatibility, routes of administration

Handling, Packaging, Storage, and Disposal

Labeling requirements, hazardous drug handling/disposal, packaging supplies, storage conditions, sharps disposal

How to Pass the CSPT Exam

What You Need to Know

Passing score: 1,400 (scaled, 1,000-1,600 range)
Exam length: 75 questions
Time limit: 1 hour 50 minutes
Exam fee: $199

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CSPT Study Tips from Top Performers

1Focus on Sterile Compounding Procedures (53%) — aseptic technique, garbing, hand hygiene, and hazardous drug handling

2Master USP <797> requirements — beyond-use dating categories, environmental monitoring, and quality assurance

3Know ISO classifications: ISO 5 (PEC), ISO 7 (buffer area), ISO 8 (ante area), and their requirements

4Study primary engineering controls: LAFW for low/medium risk, BSC for hazardous drugs, CAI/CACI for restricted access

5Practice pharmacy calculations for sterile compounding: dilutions, concentrations, flow rates, and dosing

6Review high-alert medications: insulin, heparin, chemotherapy agents, and their special handling requirements

Frequently Asked Questions

What is the CSPT certification?

CSPT (Certified Compounded Sterile Preparation Technician) is a PTCB certification for pharmacy technicians specializing in sterile compounding. It validates competency in aseptic technique, USP <797> compliance, hazardous drug handling, facilities management, and sterile preparation calculations.

How many questions are on the CSPT exam?

The CSPT exam has 75 questions (60 scored + 15 unscored) in 1 hour 50 minutes. The passing score is 1,400 on a scaled score range of 1,000-1,600. Sterile Compounding Procedures is the largest domain at 53%.

What are the prerequisites for the CSPT exam?

You must hold an active PTCB CPhT credential. Then either: Pathway 1 — PTCB-recognized sterile compounding education/training + 1 year full-time CSP experience; or Pathway 2 — 3 years full-time CSP experience within the last 8 years. A supervisor must sign a competency attestation form.

How often must I recertify the CSPT?

CSPT requires annual recertification with 10 compounding-specific CE hours and a competency attestation signed by a qualified supervisor. The renewal fee is $20 for CSPT-only or included with CPhT renewal.

How should I prepare for the CSPT exam?

Plan for 60-100 hours of study over 4-8 weeks. Focus on Sterile Compounding Procedures (53%). Master aseptic technique, garbing procedures, hazardous drug compounding with CSTDs, and pharmacy calculations. Study USP <797> requirements and ISO classifications.