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PTCB Pharmacy Technician (PTCE) Exam Cram Sheet (2026)
A free, printable PTCB Pharmacy Technician (PTCE) exam cram sheet: the 118 highest-yield points to know, grouped into 4 sections that follow the exam's content areas, each section with its published weight.
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- 300 free PTCB Pharmacy Technician (PTCE) practice questions on the same material, every one explained.
- Last updated: August 2026.
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Medications
40% of the exam- One generic, many brands
- A drug receives a single nonproprietary name through a formal naming process, but any number of manufacturers may market it under different brand names.· USAN (United States Adopted Names) Council naming conventions
- Class stems
- Shared endings signal drug class: -pril for ACE inhibitors, -sartan for angiotensin receptor blockers, -olol for beta blockers, -statin for cholesterol-lowering agents, -azole for antifungals, -cillin for penicillins, and -prazole for proton pump inhibitors.· USAN Council stem list
- Therapeutic equivalence codes
- The FDA assigns equivalence ratings to approved products, and only those rated therapeutically equivalent (A codes) are considered substitutable for the brand.· FDA Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book)
- Narrow therapeutic index caution
- Products such as levothyroxine, warfarin, and phenytoin have a small margin between an effective and a toxic dose, so many states restrict switching manufacturers without notice to the prescriber or patient.
- Combination products
- A single brand name may contain two or more active ingredients, so the technician must confirm every component and its strength rather than relying on the brand name alone.
- Cardiovascular agents
- ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics lower blood pressure and treat heart failure, while statins lower LDL cholesterol to reduce cardiovascular risk.
- Anti-infectives
- Penicillins, cephalosporins, macrolides, tetracyclines, and fluoroquinolones treat bacterial infections, while antivirals and antifungals target their own organisms; courses should be finished as directed.
- Endocrine and metabolic agents
- Insulins in rapid, short, intermediate, and long acting forms, plus metformin, sulfonylureas, and GLP-1 agonists, manage diabetes, and levothyroxine replaces thyroid hormone in hypothyroidism.
- Central nervous system agents
- SSRIs and SNRIs treat depression and anxiety, benzodiazepines treat anxiety and seizures, opioids treat pain, and anticonvulsants and antipsychotics manage seizure and psychiatric disorders.
- Gastrointestinal and respiratory agents
- Proton pump inhibitors and H2 blockers reduce gastric acid, while short-acting beta agonists serve as rescue inhalers and inhaled corticosteroids serve as daily controllers in asthma.
- Class-linked adverse effects
- Expect dry cough with ACE inhibitors, constipation and sedation with opioids, hypoglycemia with insulin and sulfonylureas, muscle aches with statins, and photosensitivity with tetracyclines and fluoroquinolones.
- Solid oral forms
- Tablets, capsules, caplets, and lozenges are the most common forms, and enteric-coated, delayed-release, and extended-release products must be swallowed whole because crushing destroys the release mechanism.
- Liquid forms
- Solutions are fully dissolved, suspensions contain undissolved particles and need a shake-well label, emulsions blend oil and water, and syrups and elixirs are sweetened vehicles.
- Parenteral routes
- Intravenous, intramuscular, subcutaneous, intradermal, and intrathecal products bypass the digestive tract, must be sterile, and are compounded inside engineering controls that maintain ISO Class 5 air.· USP <797>
- Topical and transdermal forms
- Creams, ointments, gels, and lotions act locally, while transdermal patches deliver drug systemically over hours to days; patients should rotate sites and remove the old patch before applying a new one.
- Inhalation and mucosal routes
- Metered-dose inhalers, dry-powder inhalers, and nebulizer solutions deliver drug to the lungs; ophthalmic products must be sterile, and otic products must never be placed in the eye.
- Common route abbreviations
- PO is by mouth, SL is sublingual, PR is rectal, IV is intravenous, IM is intramuscular, and SUBQ is subcutaneous; OD, OS, and OU mean right eye, left eye, and both eyes, while AD, AS, and AU mean right ear, left ear, and both ears.
- Standard temperature ranges
- Controlled room temperature is 20 to 25 degrees Celsius (68 to 77 Fahrenheit), refrigeration is 2 to 8 degrees Celsius (36 to 46 Fahrenheit), and a freezer is generally minus 25 to minus 10 degrees Celsius.· USP <659> Packaging and Storage Requirements
- Light-sensitive products
- Drugs that degrade in light must be dispensed in light-resistant containers or kept in the original carton, with an auxiliary label directing the patient to protect them from light.
- Cold chain and temperature logs
- Refrigerated products such as vaccines and biologics require documented temperature monitoring, and any excursion outside range means quarantining the stock and contacting the manufacturer before use.
- Insulin storage
- Unopened insulin stays refrigerated until its labeled expiration, while an in-use vial or pen is typically kept at room temperature for the limited number of days stated by the manufacturer.· FDA-approved manufacturer product labeling
- Controlled substance security
- Schedule II through V drugs must be stored in a securely locked, substantially constructed cabinet or dispersed throughout the non-controlled stock to deter theft.· 21 CFR 1301.75
- Expiration date versus beyond-use date
- The manufacturer sets an expiration date for the unopened original container, while the pharmacy assigns a shorter beyond-use date whenever a product is repackaged, reconstituted, or compounded.· USP <795>
- Look-alike/sound-alike pairs
- Classic confused pairs include hydralazine and hydroxyzine, prednisone and prednisolone, cefazolin and ceftriaxone, and clonidine and clonazepam.· ISMP List of Confused Drug Names
- Tall man lettering
- Mixed-case spelling such as hydrALAZINE and hydrOXYzine highlights the differing letters so the eye catches the distinction on labels, shelf tags, and screens.· FDA Name Differentiation Project
- Physical separation and shelf alerts
- Confusable products should be stored apart rather than side by side, supported by shelf stickers or system prompts that warn whoever pulls the stock bottle.
- High-alert medications
- Insulins, anticoagulants such as heparin and warfarin, opioids, concentrated electrolytes including potassium chloride, chemotherapy agents, and neuromuscular blockers carry a heightened risk of devastating harm when used in error.· ISMP List of High-Alert Medications
- Independent double checks
- High-alert preparations should be verified by a second qualified person who checks the drug, concentration, dose, and calculation without seeing the first person's work.
- Clinically significant interactions
- Watch for warfarin combined with NSAIDs or certain antibiotics, statins with strong enzyme inhibitors, several serotonergic drugs together, and additive sedation from opioids plus benzodiazepines.
Patient Safety and Quality Assurance
26.25% of the exam- Avoid error-prone abbreviations
- Do not use U for units, IU for international units, QD or QOD for daily and every other day, or MS for morphine sulfate; spell these out instead.· ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations
- Zeros in dose expressions
- Always write a leading zero before a decimal point, as in 0.5 mg, and never write a trailing zero, as in 5.0 mg, because the decimal can be missed and cause a tenfold error.· ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations
- Barcode scanning
- Scanning the stock bottle barcode during filling confirms that the product in hand matches the product on the label and catches selection errors that the eye misses.
- Clarify, do not assume
- An illegible, incomplete, or clinically questionable order must be routed to the pharmacist for clarification with the prescriber, never interpreted by the technician.
- Standardized workflow and workspace
- One prescription at a time, an uncluttered counter, and consistent placement of the label, stock bottle, and vial reduce mix-ups when the pharmacy is busy.
- Root cause thinking
- Quality-assurance programs examine the system conditions that allowed an error rather than blaming the individual, so that fixes prevent repeats.
- The rights of medication use
- Confirm the right patient, right drug, right dose and strength, right route, right time or frequency, and right documentation at every checkpoint.
- Two patient identifiers
- Verify identity using at least two identifiers such as full name and date of birth, since name alone frequently matches more than one patient in the system.
- NDC number structure
- The National Drug Code has three segments identifying the labeler, the product (drug, strength, and dosage form), and the package size, so all three must match the order.· FDA National Drug Code Directory
- Lot number and expiration check
- Confirm that the stock is not expired and record lot and expiration where required, especially for vaccines, compounded preparations, and repackaged products.
- Pharmacist final verification
- The pharmacist must complete the final check of the finished product against the original order before it is released to the patient or the nursing unit.
- Point of sale and hand-off
- At pickup, verify name and address on the bag, confirm the patient is receiving the correct prescriptions, and route any counseling request to the pharmacist.
- Remove personal items first
- Before entering the compounding area, remove outer garments, jewelry from hands and wrists, cosmetics, and artificial nails, and cover exposed hair.· USP <797>
- Garbing sequence
- Don shoe covers, head and facial hair covers, and a face mask first, then perform hand hygiene, then don the nonshedding gown, and put on sterile gloves last inside the buffer area.· USP <797>
- Hand hygiene technique
- Wash hands and forearms to the elbow with soap and water for the required duration, dry with a lint-free towel, and follow with a persistently active alcohol-based hand rub before gloving.· USP <797>
- Sterile 70 percent alcohol
- Disinfect gloves, vial stoppers, ampule necks, and the interior surfaces of the primary engineering control with sterile 70 percent isopropyl alcohol and allow it to dry.· USP <797>
- Air quality classification
- Sterile preparation occurs in ISO Class 5 air inside the primary engineering control, which sits in a cleaner-air buffer room supported by an ante-room.· USP <797>
- Work inside the hood correctly
- Keep materials at least six inches inside a laminar airflow workbench, avoid blocking first air between the filter and the critical site, and never bring in unnecessary items.
- Identify hazardous drugs
- The pharmacy must maintain a list of the hazardous drugs it handles, based on the national hazardous drug list, and assess the risk of each dosage form.· NIOSH List of Hazardous Drugs in Healthcare Settings
- Containment and negative pressure
- Hazardous drugs are compounded in a containment primary engineering control located in a negative-pressure room that is externally vented and physically separated from nonhazardous compounding.· USP <800>
- Chemotherapy PPE
- Wear two pairs of chemotherapy-rated gloves tested against permeation, a disposable back-closing gown made of a coated material, eye and face protection when splashing is possible, and a respirator when required.· USP <800>
- Segregated receiving and storage
- Hazardous drugs are unpacked in a neutral or negative-pressure area, never in a sterile compounding area, and are stored separately from other stock to limit contamination.· USP <800>
- Spill response
- A hazardous drug spill kit must be available wherever these drugs are handled, and trained personnel contain, clean, and document any spill following the pharmacy's written procedure.· USP <800>
- Labeling and waste disposal
- Finished hazardous preparations carry a warning label and are transported in sealed containers, while contaminated materials go into designated hazardous waste streams rather than regular trash.· USP <800>
- Internal event reporting
- Document errors and near misses in the pharmacy's incident system promptly and factually, describing what happened rather than assigning blame.
- MedWatch
- Serious adverse events, product quality problems, and suspected product defects are reported to the FDA voluntary reporting program.· FDA MedWatch
- National medication error reporting
- Errors and hazardous conditions can be submitted to the national medication error reporting program so that alerts and prevention guidance reach other pharmacies.· ISMP National Medication Errors Reporting Program (MERP)
- Vaccine adverse events
- Adverse events following immunization are reported to the federal vaccine adverse event system.· Vaccine Adverse Event Reporting System (VAERS)
- Pharmacist-only clinical duties
- Only the pharmacist may perform the drug utilization review, resolve clinical alerts, counsel the patient, accept a new oral prescription from a prescriber, and give the final verification.· Omnibus Budget Reconciliation Act of 1990 (OBRA 90)
- Technician scope limits
- Technicians may not make clinical judgments or transfer controlled substance prescriptions, and any expanded duty such as tech-check-tech applies only where state law and pharmacy policy specifically authorize it.
Order Entry and Processing
21.25% of the exam- Required elements of a prescription
- A valid order shows the patient's name and address, the date issued, the drug name, strength, and quantity, complete directions for use, refill authorization, and the prescriber's name, address, and signature.
- Patient profile setup
- Record demographics, allergies, current medications, disease states, and insurance details so the system can screen for interactions and duplicate therapy.
- Electronic prescriptions
- E-prescriptions arrive already structured, but the technician still confirms drug, strength, quantity, and directions against the transmitted record instead of assuming the data is correct.
- Refills and authorization
- Refills are dispensed only within the number and time frame authorized, and requests beyond that must go to the prescriber for new authorization.
- Third-party claim fields
- Claims require the correct BIN, PCN, group number, member ID, and person code, and rejections often trace to a mismatch in one of these fields or in days supply.
- Prior authorization and rejections
- When a plan rejects a claim for prior authorization, quantity limits, or non-formulary status, the technician documents the message and routes the clinical decision to the pharmacist or prescriber.
- Frequency abbreviations
- QD is once daily, BID is twice daily, TID is three times daily, QID is four times daily, QAM is every morning, QHS is at bedtime, and q4h means every four hours.
- Quantity and form abbreviations
- Common terms include tab for tablet, cap for capsule, gtt for drop, tsp for teaspoonful (5 mL), tbsp for tablespoonful (15 mL), and ss for one half.
- Condition and timing terms
- PRN means as needed, AC is before meals, PC is after meals, HS is at bedtime, and UD or UT DICT means use as directed.
- Translating a sig
- The sig i tab PO BID PRN pain becomes Take one tablet by mouth twice daily as needed for pain, written in plain language at an accessible reading level.
- Dangerous abbreviations
- Reject or clarify orders using U, IU, QD, QOD, cc, or a trailing zero, because each has been repeatedly misread as a different value.· ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations
- Auxiliary label selection
- The sig and the dosage form drive auxiliary labels such as shake well, take with food, may cause drowsiness, avoid sunlight, and do not crush or chew.
- Days supply formula
- Divide the total quantity dispensed by the total amount used per day, so 60 tablets taken twice daily equals a 30-day supply.
- Liquid days supply
- Convert the sig to milliliters per day and divide the bottle volume by that number, remembering that one teaspoonful equals 5 mL and one tablespoonful equals 15 mL.
- Insulin days supply
- Standard insulin is 100 units per mL, so a 10 mL vial contains 1000 units and a patient using 40 units per day has a 25-day supply.
- Weight-based dosing
- Convert pounds to kilograms by dividing by 2.2, then multiply the kilogram weight by the milligrams per kilogram to reach the dose.
- Ratio and proportion
- Set the known concentration equal to the unknown quantity in the same units and cross multiply, which handles most strength and volume conversions.
- Metric conversions
- One kilogram equals 1000 grams, one gram equals 1000 milligrams, one milligram equals 1000 micrograms, one liter equals 1000 milliliters, and one fluid ounce is about 30 mL.
- Percent strength
- Percent weight in volume is grams per 100 mL, percent weight in weight is grams per 100 grams, and percent volume in volume is milliliters per 100 mL.
- Ratio strength
- A ratio strength such as 1:1000 means one gram of drug in 1000 mL of solution, which equals one milligram per milliliter.
- Dilution formula
- Use the first concentration times the first volume equals the second concentration times the second volume to find how much stock solution and diluent are needed.
- Alligation
- When mixing a higher and a lower strength to reach a desired middle strength, subtract diagonally to find the number of parts of each component, then convert parts to actual quantities.
- IV flow rate in mL per hour
- Divide the total infusion volume by the infusion time in hours, so 1000 mL over 8 hours runs at 125 mL per hour.
- Drop rate
- Multiply the milliliters per minute by the administration set drop factor in drops per milliliter to obtain drops per minute.
- Average wholesale price and markup
- Markup is the selling price minus the acquisition cost, and the markup percentage is that difference divided by the cost, while reimbursement formulas often start from average wholesale price minus a discount plus a dispensing fee.
- Gross profit and discounts
- Gross profit is revenue minus cost of goods sold, and a discount reduces the price by the stated percentage of the original amount.
- Inventory control
- Turnover equals annual cost of goods sold divided by average inventory value, and par levels with reorder points keep fast movers in stock without overbuying.
- Prescription label elements
- The dispensed label must show the pharmacy name and address, prescription number, date, patient name, prescriber name, drug name and strength, quantity, directions, refills remaining, and beyond-use or expiration date.
- Child-resistant packaging
- Most oral prescription drugs must be dispensed in child-resistant containers unless the prescriber or the patient requests otherwise in the manner allowed by law.· Poison Prevention Packaging Act of 1970
- Repackaging beyond-use dates
- A repackaged solid oral dose in a unit-dose container is given a beyond-use date no later than one year from repackaging or the manufacturer expiration date, whichever comes first, unless stability data support otherwise.· USP <795>
Federal Requirements
12.5% of the exam- Schedule I
- These substances have a high potential for abuse and no currently accepted medical use in the United States, so they cannot be prescribed and are limited to approved research.· Controlled Substances Act, 21 USC 812
- Schedule II
- High abuse potential with accepted medical use and severe dependence risk, including many opioid analgesics, stimulants used for attention disorders, and certain barbiturates.· Controlled Substances Act, 21 USC 812
- Schedule III
- Abuse potential less than Schedules I and II, with moderate to low physical dependence and high psychological dependence, including certain combination products and anabolic steroids.· Controlled Substances Act, 21 USC 812
- Schedules IV and V
- Schedule IV has lower abuse potential than Schedule III and includes many benzodiazepines, while Schedule V has the lowest potential and includes limited-quantity cough preparations containing codeine.· Controlled Substances Act, 21 USC 812
- Pseudoephedrine sales limits
- Nonprescription products containing pseudoephedrine must be kept behind the counter, sold within daily and monthly quantity limits, and logged with purchaser identification.· Combat Methamphetamine Epidemic Act of 2005
- No refills on Schedule II
- A Schedule II prescription may not be refilled, so each fill requires a new prescription from the prescriber.· 21 CFR 1306.12
- Emergency Schedule II dispensing
- In a genuine emergency a pharmacist may dispense a limited quantity on an oral order, and the prescriber must deliver a written prescription to the pharmacy within seven days.· 21 CFR 1306.11
- Refill limits on Schedules III through V
- These prescriptions may be refilled up to five times within six months of the date issued, after which a new prescription is required.· 21 CFR 1306.22
- Partial fills
- Partial filling is permitted under defined conditions, including at the request of the patient or prescriber for Schedule II, with the balance supplied within the time limits set by regulation.· 21 CFR 1306.13
- Required prescription elements
- A controlled substance prescription must be dated and signed on the day issued and must show the patient name and address, the prescriber name, address, and DEA registration number, and the drug, strength, quantity, and directions.· 21 CFR 1306.05
- DEA number verification
- Add the first, third, and fifth digits, add the second, fourth, and sixth digits and multiply that sum by two, then add the two results; the last digit of the total must match the final digit of the DEA number.
- Form 222 and CSOS ordering
- Schedule I and II substances may be ordered only using DEA Form 222 or its electronic equivalent through the Controlled Substance Ordering System.· 21 CFR 1305
- Registration with Form 224
- A retail pharmacy applies for DEA registration using Form 224 and renews it periodically to remain authorized to dispense controlled substances.· 21 CFR 1301.13
- Reporting theft or significant loss
- A pharmacy must notify the DEA upon discovering a theft or significant loss and document it on DEA Form 106.· 21 CFR 1301.74
- Documenting destruction
- Controlled substances destroyed by an authorized method are recorded on DEA Form 41.· 21 CFR 1317
- Biennial inventory
- A complete inventory of all controlled substances on hand must be taken at least every two years, with Schedule II records kept separate from other records.· 21 CFR 1304.11
- Record retention
- Controlled substance records must be kept for at least two years and be readily retrievable for inspection by the DEA.· 21 CFR 1304.04
- Class I recall
- A Class I recall applies when there is a reasonable probability that using the product will cause serious adverse health consequences or death.· 21 CFR 7.3
- Class II recall
- A Class II recall applies when the product may cause temporary or medically reversible adverse health consequences, and the probability of serious harm is remote.· 21 CFR 7.3
- Class III recall
- A Class III recall applies when use of the product is not likely to cause adverse health consequences, such as certain labeling or packaging defects.· 21 CFR 7.3
- Handling a recall in the pharmacy
- Quarantine the affected lots immediately, stop dispensing, follow the manufacturer's return instructions, and notify affected patients as directed by the pharmacist.
- Risk Evaluation and Mitigation Strategies
- Certain drugs require an approved risk program that may include prescriber and pharmacy enrollment, patient enrollment, laboratory monitoring, and documentation before each dispensing.· Food and Drug Administration Amendments Act of 2007
- Medication Guides and drug supply security
- Medication Guides must be provided with certain products at each dispensing, and transaction information for prescription drugs must be verified and retained under drug supply chain rules.· Drug Supply Chain Security Act (DSCSA)
- Nonsterile compounding
- Nonsterile preparation covers products such as capsules, creams, and oral liquids, and requires trained personnel, a master formulation record, a compounding record, and an assigned beyond-use date.· USP <795>
- Sterile compounding
- Sterile preparation requires ISO classified air, garbing and hand hygiene, personnel competency testing including media fill, environmental monitoring, and beyond-use dating based on category and storage.· USP <797>
- Hazardous drug standard
- Facilities that handle hazardous drugs must maintain a written plan, a designated responsible person, containment engineering controls, and documented training for all personnel.· USP <800>
- Protected health information
- Individually identifiable health information may be used and disclosed for treatment, payment, and health care operations, and otherwise generally requires patient authorization.· HIPAA Privacy Rule
- Minimum necessary and safeguards
- Disclose only the minimum information necessary for the purpose, and protect records through secure storage, private counseling areas, and controlled system access.· HIPAA Privacy Rule
- Notice of Privacy Practices
- The pharmacy must give patients a notice describing how their health information is used and disclosed and their rights to access and amend it.· HIPAA Privacy Rule
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