PTCB Order Entry 4/6

A pharmacy technician is asked to divide a bulk bottle of chloral hydrate 500 mg/5 mL into 1 tsp unit-of-use packaging. The best option for portioning out the drug is to use a(n):

• oral liquid syringe.

• medicine cup.

• small glass bottle.

• hypodermic syringe.

Answer explanation

Oral liquid syringes are appropriate to use with oral medications and can provide a precise measurement for 1 tsp (5 mL). Options (B), (C), and (D) either are inappropriate to use with oral medications or do not provide a precise measurement of the required quantity.

A stock bottle labeled with NDC number 00046-0867-81 contains the same medication as a bottle labeled with which of the following NDC numbers?

• 00046-0867-91

• 00867-0046-81

• 00046-0866-81

• 00081-0867-46

Answer explanation

The first segment of a National Drug Code (NDC) number, also known as the labeler code, indicates which firm manufactures (including repackers or relabelers) or distributes (under its own name) a drug; the middle segment, also known as the product code, identifies a specific strength, dosage form, and formulation of a drug for a particular manufacturer or labeler; and the third segment, also known as the package code, identifies package sizes and types. The first and second segments in only option (A) match those in the question.

An order for a 1 mg atropine injection is filled using a vial labeled 0.4 mg/mL. What volume of the solution, in mL, should be administered?

• 0.4

• 1.5

• 2

• 2.5

Answer explanation

You know that there are 0.4 mg of atropine in 1 mL, by setting up a proportion and solving for x, you can calculate how many mL will provide 1 mg of atropine.

(0.4 mg/1 mL) = (1 mg/x mL) x = 2.5 mL

When verifying National Drug Codes on a received shipment, a pharmacy technician discovers that the supplier filled a purchase order for NDC 0093-3145-05 with NDC 0093-3107-05. The pharmacy technician realizes that the item received:

• was made by a different manufacturer than the item on the purchase order.

• is in a different package size than the item on the purchase order.

• is generically equivalent to the item on the purchase order.

• contains a different strength, form, or formulation than the item on the purchase order.

Answer explanation

The middle segment of a National Drug Code (NDC) number, also known as the product code, identifies a specific strength, dosage form, and formulation of a drug for a particular manufacturer or labeler. The first segment, also known as the labeler code, is assigned by the Food and Drug Administration (FDA). A labeler is any firm that manufactures (including repackers or relabelers) or distributes (under its own name) a drug. The third segment, also known as the package code, identifies package sizes and types. In this scenario, only the products' middle segments differ, meaning that the products' strengths, dosage forms, and/or formulations may be different.

Vials of 0.25 mg/5 mL Aloxi contain sufficient overfill to prepare 11 pre-filled syringes from 10 vials of drug. The number of pre-filled syringes that can be prepared from 50 vials of drug is:

• 50

• 55

• 500

• 550

Answer explanation

This problem is telling you that 11 pre-filled syringes can be prepared from 10 vials of Aloxi. You can set up a proportion to determine how many pre-filled syringes can be filled from 50 vials of the drug. The drug concentration is extra information that is not needed to solve this problem.

(11 syringes/10 vials) = (x syringes/50 vials) x = 55 syringes

What amounts of hydrocortisone ointment and ointment base, in g, are needed to compound a 480 g ointment preparation of hydrocortisone 10%?

• 4.8 g hydrocortisone; 475.2 g base

• 4.8 g hydrocortisone; 432 g base

• 48 g hydrocortisone; 432 g base

• 48 g hydrocortisone; 480 g base

Answer explanation

The first step to answer this question is to calculate how many g of hydrocortisone will be contained in the final product. This requires the understanding that 10% hydrocortisone ointment means that 10 g of hydrocortisone will exist in 100 g of total hydrocortisone ointment. This can be calculated by setting up a proportion and solving.

(10 g hydrocortisone/100 g hydrocortisone ointment) = (x g hydrocortisone/480 g hydrocortisone ointment) x = 48 g hydrocortisone

The next step is to determine the volume of ointment base needed to create a total of 480 g of hydrocortisone and base. This can be determined as follows, by solving for x:

480 g total ointment = 48 g hydrocortisone + x g base

x = 432 g

A pharmacy technician is preparing 240 mL of lidocaine/diphenhydramine/Maalox at a ratio of 1:2:1. How much of each product does the technician need?

• 30 mL lidocaine, 60 mL diphenhydramine, 30 mL Maalox

• 60 mL lidocaine, 120 mL diphenhydramine, 60 mL Maalox

• 100 mL lidocaine, 200 mL diphenhydramine, 100 mL Maalox

• 120 mL lidocaine, 240 mL diphenhydramine, 120 mL Maalox

Answer explanation

In order to solve this problem, you need to understand ratios. A ratio of 1:2:1 means that there are 4 total parts in the preparation (1 part + 2 parts + 1 part = 4 parts). Using percent rules, we can determine the percentage of each ingredient in the preparation and then multiply by the total volume. Both lidocaine and Maalox take up 1 of the 4 parts or 25% (1 ÷ 4 × 100% = 25%) and the diphenhydramine takes up 2 of the 4 parts or 50% (2 ÷ 4 × 100% = 50%). You can do a quick double check to ensure all of the parts are equal to 100% (25% lidocaine + 50% diphenhydramine + 25% Maalox = 100%). We can now use these percentages to determine the volume we need of each ingredient. This is most easily done by converting the percentage to a decimal by moving the decimal point two places to the left and multiplying by the total volume.

(0.25 × 240 mL) = 60 mL lidocaine and Maalox
(0.5 × 240 mL) = 120 mL diphenhydramine

You can also add all of the quantities together to ensure they equal 240 mL to double check your work (60 mL lidocaine + 120 mL diphenhydramine + 60 mL Maalox = 240 mL)

You can solve this in an alternative way by using proportions. You already established above that there are 4 total parts, so there would be 4 total parts in 240 mL in this scenario. You then can determine how many mL are needed for 1 or 2 parts.

(4 parts/240 mL) = (1 part/x mL) x = 60 mL lidocaine and Maalox
(4 parts/240 mL) = (2 parts/x mL) x = 120 mL diphenhydramine

A pharmacy receives the following prescription order: Rifampin suspension 25 mg/mL Sig: 7 mL q.i.d. x 4 days What quantity of 300 mg rifampin capsules must be used to compound this suspension?

• 4

• 9

• 10

• 11

Answer explanation

In order to answer this question, you must first understand the abbreviations. "q.i.d." means four times daily.

To determine the total amount of Rifampin required, you can use a proportion and solve for x.

(x mg/7 mL) = (25 mg/1 mL) x = 175

Next, you must multiply 175 by four (four times daily) and by four again (four days) to determine the total amount of drug needed for the prescription.

175 mg/dose x 4 doses/day x 4 days = 2800 mg

2800 mg must then be divided by 300 mg per capsule to determine the total number of capsules. As this comes out to 9.3 capsules, you must round up to 10 capsules get enough drug to get a full 2800 mg of Rifampin.

The quantity of sodium bicarbonate powder required to make 50 mL of a 0.5% solution is:

• 100 mg.

• 250 mg.

• 0.5 g.

• 50 g.

Answer explanation

To answer this question, you need to calculate how many g of pure sodium bicarbonate powder will be required to make 50 mL that has a strength of 0.5%. The 0.5% strength means that there are 0.5 g of sodium bicarbonate in 100 mL of the solution. You can calculate how many g of sodium bicarbonate powder are needed by setting up a proportion and solving for x.

(0.5 g/100 mL) = (x g/50 mL) x = 0.25 g sodium bicarbonate powder

Since there are 1000 mg in 1 g, you can use this information to convert 0.25 g to mg by using a proportion and solving for x or you can move the decimal 3 places to the right since the numbers differ by a factor of 3.

(1000 mg/1g) = (x mg/0.25 g) x = 250 mg

How many grams of dextrose are contained in 400 mL of 70% dextrose solution?

• 120

• 280

• 400

• 700

Answer explanation

A 70% dextrose solution means that there are 70 g of dextrose per 100 mL of solution. Set up a proportion to find how many g of dextrose are in 400 mL of solution.

70 g/100 mL = x/400 mL
x = 280 g