1. Which of the Following Cannot Be Refilled Under Any Circumstances? A. Metoprolol B

1. Which of the following cannot be refilled under any circumstances?
a. Metoprolol
b. Methylphenidate
c. Mitomycin
d. Hydroxyurea

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1. (b) Methylphenidate is a controlled class II drug. It is indicated for treatment of attention deficit hyperactivity disorder (ADHD). It cannot be refilled under any circumstances.

2. Valproic acid syrup is available as 250 mg/5 cc. If a patient were taking 1000 mg in the morning and 750 mg in the evening, how many cc of syrup would you dispense for a 30-day supply ?
a. 1500 cc
b. 1050 cc
c. 500 cc
d. 480 cc

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2 (b)1050cc. In this type of calculation first find out number of cc required for 1 day.
Morning dose
Drug ml of solution
250 mg present 5 cc of solution
1000 mg ?
1000 x 5cc / 250 = 20 cc of solution.
Evening dose
Drug ml of solution
250 mg present in 5 cc of solution
750 mg ?
750 x 5cc / 250 = 15 cc of solution.
For a 30 day supply of Valproicacid
(20 cc (am) + 15 cc (pm) ) x 30 = 1050cc.

3. If a patient were taking Glyburide for his type II diabetes, and a physician prescribed him Chlorpropamide, a pharmacy technician would:
a. Fill the prescription.
b. Notify a pharmacist about the duplication of therapy.
c. Notify a pharmacist about the drug-food interaction.
d. All of the above.

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3. (b)Glyburide and Chlorpropamide are oral sulfonylurea agents indicated for treatment of diabetes. Pharmacy technician will notify the pharmacist about duplication of therapy.

4. All of the following drugs should be carefully prescribed with aspirin EXCEPT:
a. Enoxaparin
b. Coumadin
c. Heparin
d. Metoclopramide

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4. (d)Aspirin is a blood thinning agent indicated for prevention of heart stroke. It should be carefully prescribed with other blood thinning agents
because of risks of bleeding. Lovenox (Enoxaparin), Coumadin (Warfarin), Heparin, Plavix (Clopidogrel), Ticlid (Ticlopidine), Depakene (Valproic acid), Persantine (Dipyridamole), Mandol (Cefamandole), Cefotan (Cefotetan), Cefobid (Cefoperazone) and Moxam (Moxalactam) are agents that increase bleeding tendency in patients and should be carefully prescribed with other blood thinning agents.

5. An overdose of Coumadin can be treated by administering:
a. Vitamin K
b. Acetylcysteine
c. Mesna
d. Protamine sulfate

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5. (a)The overdose of Coumadin can be treated by administration of Vitamin K1 (Mephyton).

6. Prochlorperazine can be classified as an:
a. Anti-emetic
b. Anti-depressant
c. Anti-anxiety
d. Anti-hypertensive

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6. (a)Compazine (Prochlorperazine) is indicated for treatment of nausea and vomiting and therefore is classified as an anti-emetic (agent that prevent nausea and vomiting).

7. A patient is taking Amoxicillin 500 mg by mouth three times a day for 7 days. How many capsules of 500 mg of Amoxicillin will you dispense for the whole supply?
a. 42
b. 21
c. 7
d. 30

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7. (b).

8. The cost for 100 tablets of Olanzapine is $420.00. The percentage mark up on the prescription is 15. What will be the retail cost for 30 tablets of the above drug ?
a. $200
b. $145
c. $300
d. $450

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8. (b)The cost of 100 tablets of Olanzapine is $420 and therefore the cost of one tablet of Olanzapine would be $420/100 = $ 4.20.
The % mark-up on the prescription is 15%
Cost of prescription mark up on rx
$ 100 $ 15
$ 4.20 ?
15 x 4.20 / 100 = $ 0.63, therefore dispensing cost of each prescription would be
$ 4.20 + $ 0.63 = $ 4.83
The cost of 30 tablets would be $ 4.83 x 30 = $145.

9. How much quantity of 3% Salicylic acid powder is required to mix with a talc powder to prepare a 0.20%, 500 grams of Salicylic acid?
a. 50 gm
b. 33 gm
c. 480 gm
d. 57 gm

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9. (b)33 grams. For calculations of this type the allegation method is very useful. We want to prepare 500 gm of 0.2 % salicylic acid by mixing talc (0 %) powder with 3 % of Salicylic acid powder.
3 % salicy 0.2 (3 % sali)
0.2 %
0 % talc (no salicy) 2.8 (0% sali)
Total 3.0 (0.2 % sali)
We want to find out how many grams of 3 % salicylic acid required
Total parts of 0.2% sali Parts of 3 % sali
3 parts 0.2 parts 500 ?
500 x 0.2 / 3 = 33 grams of 3% salicylic acid required.

10. Clopidogrel is classified as an:
a. Anti-hypertensive.
b. Inhibitor of platelets' aggregation.
c. Anti-diabetic.
d. Anti-Parkinson's.

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10. (b)Plavix (Clopidogrel) is a blood thinning agent. Agents of this class generally act by inhibiting aggregation of platelets which is thought to be the primary mechanism of blood clotting. It is indicated for prevention of heart stroke in patients with CHF.

11. All of the following drugs can be indicated for the treatment of asthma EXCEPT:
a. Ipratropium
b. Metoprolol
c. Albuterol
d. Zafirlukast

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11. (b)Asthma is characterized by increased responsiveness of trachea and bronchi to various stimuli and narrowing of airways. It is associated with shortness of breath, chest tightness, wheezing and coughing. The Beta-2 receptors stimulation generally dilates the bronchial smooth muscles and helps in controlling asthma.
Beta-2 receptors blockers generally constrict the smooth muscles of bronchi and may even aggregate asthma.
Metoprolol is a Beta-1 and Beta-2 receptor blockers indicated for treatment of hypertension and should be carefully prescribed in patient with asthma. Other choices such as Accolate and Atrovent are indicated for treatment of asthma.

12. A prescription for MS Contin 30 mg was written as follows:
Manan Care Rx
Mr. Shroff 1/1/01
Ms Contin 30 mg
sig- 1 potid x 30 day
# 60
Dr. Bhatia 1/1/02
Refill-0 MHS
DEA # AB2354760
What would be the dispense quantity for the above prescription?
a. 90
b. 60
c. 30
d. 10

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12. (b)The prescription of CII controlled drugs should be dispensed with specific quantity mentioned on prescription by physician. MS-contin is a controlled II drug and therefore correct dispensing quantity would be 60.

13. A patient requests a refill for Diazepam 10mg. Upon reviewing his profile, a pharmacy technician reveals that the prescription for the requested drug has been refilled 5 times. The pharmacy technician will:
a. Refill the prescription since it has been written for prn times.
b. Cannot refill. Notify a pharmacist.
c. Asks the patient to provide a valid DEA 222 order form.
d. Refuse to fill since the strength of the requested medication is commercially unavailable.

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13. (b)Prescription of controlled drugs III, IV and V cannot be refilled more than 5 times. A patient must bring a new prescription after this allowable refill is executed. Prescriptions older than 6 months require a new prescription to fill.

14. Which of the following auxiliary labels is required when dispensing Otocortotic solution?
a. Take with food.
b. Do not consume alcoholic beverages.
c. For ear use only.
d. Shake well before using.

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14. (c)Otocortotic solution is intended for ear use only. It should not be applied to eyes and therefore the auxiliary label "For ear use only" is required.

15. All of the following drugs are colony and erythrocytes stimulating agents EXCEPT:
a. Filgrastim.
b. Epoetin.
c. Tamsulosin.
d. Sargramostim.

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15. (c)Tamsulosin is the generic name of Flomax. It is indicated for treatment of B.P.H. All of the rest of the choices are colony stimulator agents. They generally help in stimulation of erythrocyte and granulocytes.

16. Lanoxin pediatric solution is available in 0.05 mg/ml. If a patient is taking 0.25 mg of Lanoxin per day, what will be the dispense quantity of the drug in a cc for a 30-day supply?
a. 25 cc
b. 50 cc
c. 100 cc
d. 150 cc

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16. (d)150 cc. Lanoxin is available in 0.05 mg/ml. Patient is taking 0.25 mg per day.
Drug ml of solution
0.05 mg 1 ml
0.25 mg ?
0.25 x 1 / 0.05 = 5ml
for 30 days supply = 30 x 5cc = 150cc

17.Which of the following drugs is classified as a controlled substance?
a. Cipro
b. Vibramycin
c. Lyrica
d. Antara

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17.(c) Lyrica (Pregabalin) is classified as a Schedule V controlled substance.It is indicated for:
1. Management of neuropathic pain associated with diabetic peripheral neuropathy
2. Management of postherpetic neuralgia
3.Adjunctive therapy for adult patients with partial onset seizures
4.Management of fibromyalgia
5. Management of neuropathic pain associated with spinal cord injury

18. A prescription for Cymbalta can be filled by selecting:
a. Lidocaine
b. Tramadol
c. Duloxetine
d. Diclofenac

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18.(c) A prescription for Cymbalta can be filled by selecting Duloxetine. It is indicated for treatment of depression.

19.What is the principal side effect of Acarbose (Precose)?
a. Hyperglycemia
b. Bloating and diarrhea
c. Severe constipation
d. Bleeding

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19.(b) Acarbose (Precose) is an oral alpha-glucosidase inhibitor for use in the management of type 2 diabetes mellitus. It delays the digestion of ingested carbohydrates, thereby resulting in a smaller rise in blood glucose concentration following meals. As a consequence of plasma glucose reduction, Precose reduces levels of glycosylated hemoglobin in patients with type 2 diabetes mellitus.

The recommended starting dosage of Acarbose (Precose) is 25 mg given orally three times daily at the start (with the first bite) of each main meal . However, some patients may benefit from more gradual dose titration to minimize gastrointestinal side effects. This may be achieved by initiating treatment at 25 mg once per day and subsequently increasing the frequency of administration to achieve 25 mg t.i.d.

Hypoglycemia, gas, bloating and diarrhea are commonly reported side effects of Acarbose (Precose).

20. “Prescription” means:
I. An order given individually for the person for whom prescribed, directly from the practitioner, or the practitioner’s agent, to a pharmacist.
II. A chart order written for an inpatient specifying drugs which he or she is to take home upon discharge.
III. A chart order written for an inpatient for use while he or she is an inpatient.
a. I only
b. I and II only
c. II and III only
d. All

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20. Answer: (b). 1. "Prescription" means:
(a).An order given individually for the person for whom prescribed, directly from the practitioner, or the practitioner's agent, to a pharmacist or indirectly by means of an order signed by the practitioner or an electronic transmission from the practitioner to a pharmacist.
(b).A chart order written for an inpatient specifying drugs which he or she is to take home upon discharge.
2. "Prescription" does not include a chart order written for an inpatient for use while he or she is an inpatient.

A pharmacy technician may NOT perform which of the following tasks?
I. Accept an original prescription drug order by telephone.
II. Perform patient counseling.
III. Sign any federally-required controlled substance or inventory form.
a. I only
b. I and II only
c. II and III only
d. All

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Answer: (d). All listed tasks cannot be performed by a pharmacy technician. The pharmacist in charge or the retail drug outlet shall determine the duties of pharmacy technicians based upon the needs of the drug outlet.
At time of employment the pharmacist in charge shall provide the technician with a description of the tasks that the technician may perform.
Pharmacy technicians are limited to performing tasks in the preparation of prescription legend drugs and nonjudgmental support services.
Permissible duties include the dispensing of drugs under the direct supervision of a pharmacist. Pharmacy technicians may also have access to a facsimile machine or computer used to receive original prescription drug orders via facsimile.
A pharmacy technician may not perform any of the following tasks:
A. Accept an original prescription drug order by telephone;
B. Clinically evaluate a patient profile relative to drugs that have or will be dispensed;
C. Perform patient counseling or suggesting over-the-counter or prescription products to a patient;
D. Make decisions that require the education and professional training of a pharmacist; or
E. Sign any federally-required controlled substance or inventory form.

22. All of the following vaccines can be stored in a refrigerator EXCEPT:
a. Influenza
b. Hep B
c. Rotavirus
d. HZV

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22. Answer:(d). CDC Vaccine Storage Recommendations List:
Vaccines Require To Be Stored In Referigerator (2 to 8 degrees C):

HepA
HepB
HepA-HepB
Hib (Haemophilusinfluenzae type b)
Hib-HepB
HPV (Human papilloma virus)
Influenza
Meningococcal-combinations
MMRa* (Measles, mumps, rubella)
Pneumococcal
Rotavirus
Any diphtheria/tetanus toxoid, pertussis combination

Vaccines Require To Be Stored In Freezer (-50 to -15 degrees C):

VAR Varicella
HZV (Herpes Zoster Vaccine)
MMRa (Measles, mumps, rubella)
MMRV (Measles, mumps, rubella, varicella)

* Can be stored in freezer or referigerator.

23. In a near future, which of the following nasal corticosteroids will be available OTC?
a. Nasacort AQ
b. Nasonex
c. Omnaris
d. Flonase
e. Vancenase AQ

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23. Answer: (d), Flonase. The U.S. Food and Drug Administration (FDA) has approved Flonase Allergy Relief (fluticasone propionate 50 mcg spray)as an over-the-counter (OTC) treatment for temporary relief of the symptoms of hay fever or upper respiratory allergies.
Flonase Allergy Relief is the first and only over-the-counter nasal spray indicated for relief of all nasal and eye-related allergy symptoms3,4 including runny nose, sneezing, itchy nose, nasal congestion and itchy and watery eyes.Flonase Allergy Relief will be available at full prescription strength and to provide 24-hour non-drowsy allergy relief.

24. Which of the following information about the Ebola virus is/are TRUE?
I. There's no cure or vaccine for Ebola.
II. Ebola wreaks life-threatening havoc within the body by attacking multiple organ systems at the same time.
III. Experts stress that early and intense medical care can greatly improve a person's chances of survival.
a. I only
b. I and II only
c. II and III only
d. All

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24. Answer: (d), All. The Ebola virus currently raging in West Africa has a well-earned reputation as one of the world's most deadly illnesses. But experts stress that early and intense medical care can greatly improve a person's chances of survival.
There's no cure or vaccine for Ebola, which wreaks life-threatening havoc within the body by attacking multiple organ systems at the same time.
Instead, doctors must fall back on the basics of "good meticulous intensive care," supporting the patient and targeting treatment toward the organs that are under attack by the virus.
The virus is particularly tough to combat because once it gets into the human body, it attacks so many different tissues. In contrast, most viruses tend to target one specific organ. For example, influenza goes after the respiratory system.
Ebola attacks every organ system, including the heart, lungs, brain, liver and kidneys. It even attacks a person's blood, thinning it and causing Ebola's trademark bleeding from multiple orifices.

25. Which of the following information about Cardioviva is/are TRUE?
I. It is a natural, over-the-counter probiotic supplement.
II. It is clinically proven to support healthy knee cartilage in adults.
III. The probiotic strain in Cardioviva is Lactobacillus acidophilus.
a. I only
b. I and II only
c. III only
d. II and III only
e. All

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25. (a) I only, Cardioviva is a natural, over-the-counter probiotic supplement. The probiotic strain in Cardioviva is Lactobacillus reuteri. It is clinically proven to support healthy Cholesterol levels in adults. The suggested dose is one 100 mg capsule twice daily with meals. Gas and bloating are commonly reported side effects of Cardioviva.

26. Which of the following information is/are TRUE about Ebola Hemorrhagic Fever?
I. It is a viral hemorrhagic fevers.
II. It is a severe, often fatal disease in humans and nonhuman primates.
III. It is caused by infection with a virus of the family Filoviridae.
a. I only
b. I and II only
c. III only
d. II and III only
e. All

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26. Answer:(d), All. Ebola hemorrhagic fever (Ebola HF) is one of numerous Viral Hemorrhagic Fevers. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees).
Ebola HF is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. When infection occurs, symptoms usually begin abruptly. The first Ebolavirus species was discovered in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. Since then, outbreaks have appeared sporadically.
There are five identified subspecies of Ebolavirus. Four of the five have caused disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d'Ivoire ebolavirus); and Bundibugyo virus (Bundibugyoebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.

27. Which of the following statements are TRUE about S.T.E.P.S. Programs?
I. All prescriptions prescribed under these programs must be filled within 3 days.
II. Prescribe no more than 4 weeks (28 days) of therapy, with no automatic refills.
III. All prescribers must register in the S.T.E.P.S. Prescriber Registry via the Prescriber Registration Card that is located in every S.T.E.P.S. folder.
a. I only
b. I and II only
c. II and III only
d. All

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27. Answer:II and III only.
1. S.T.E.P.S. stands for System for Thalidomide Education and Prescribing Safety, a proprietary education and restrictive distribution program for Thalomid (Thalidomide).
The S.T.E.P.S. program was developed because of the toxicity associated with fetal exposure to Thalomid (Thalidomide) and to minimize the chance of fetal exposure to Thalomid (Thalidomide).
2. Thalidomide in combination with Dexamethasone is indicated for the treatment of patients with newly diagnosed multiple myeloma and ErythemaNodosumLeprosum.
3. All prescribers must register in the S.T.E.P.S. Prescriber Registry via the Prescriber Registration Card that is located in every S.T.E.P.S. folder.
4. Only licensed prescribers may register. They should complete, sign, and return the Prescriber Registration Card. Prescriptions cannot be issued by telephone under this program.
5. Prescribers shall not prescribe more than 4 weeks (28 days) of therapy with no automatic refills. A patient shall be informed that all prescriptions must be filled within 7 days (NOT 3 days).

28. FDA has recently approved Contrave (Naltrexone hydrochloride and Bupropion hydrochloride extended-release tablets). Contrave is indicated for the treatment of:
a. Management of smoking cessation.
b. Treatment of seizure.
c. Management of chronic weight reduction.
d. Treatment of atypical depression.
e. Management of an opioid abuse.

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28. Answer: Management of chronic weight reduction. The U.S. Food and Drug Administration today approved Contrave (Naltrexone hydrochloride and Bupropion hydrochloride extended-release tablets) as treatment option for chronic weight management in addition to a reduced-calorie diet and physical activity.
The drug is approved for use in adults with a body mass index (BMI) of 30 or greater (obesity) or adults with a BMI of 27 or greater (overweight) who have at least one weight-related condition such as high blood pressure (hypertension), type 2 diabetes, or high cholesterol (dyslipidemia).
The most common adverse reactions reported with Contrave include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea.

29. Which of the following active ingredients found in Fosamax Plus D?
a. Vitamin D1
b. Vitamin D2
c. Vitamin D3
d. Vitamin D4

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29. Vitamin D3. Alendronate sodium is a bisphosphonate that acts as a specific inhibitor of osteoclast mediated bone resorption. Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.
FosamaxPlus D contains Alendronate sodium, a bisphosphonate, and Cholecalciferol (vitamin D3). Cholecalciferol (vitamin D3) is a secosterol that is the natural precursor of the calcium-regulating hormone calcitriol (1,25dihydroxyvitamin D3).
It is indicated for the treatment of osteoporosis in postmenopausal women and to increase bone mass in men with osteoporosis.
The recommended dosage is one 70 mg Alendronate/2800 international units vitamin D3 or one 70 mg Alendronate/5600 international units vitamin D3 tablet once weekly.