Chapter 1 of 440% of exam
Medications
Medications make up the largest share of the PTCE, covering how drugs are named, classified, formulated, stored, and kept safe. This chapter builds the working vocabulary a pharmacy technician uses at the counter, in the IV room, and at the shelf.
Generic and Brand Names
Every drug carries one nonproprietary (generic) name and may carry several proprietary (brand) names owned by manufacturers. Generic names are built from standardized stems that reveal the drug class, which makes them a shortcut for learning hundreds of products. Technicians must match the two names accurately during data entry and substitution.
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 conventionsClass 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 listTherapeutic 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.
Major Drug Classes and What They Treat
Learning drugs by class lets a technician predict the indication, the counseling points, and the typical adverse effects. The classes below account for the bulk of retail and hospital volume. Each class also carries a signature side effect pattern worth memorizing.
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.
Dosage Forms and Routes of Administration
The dosage form determines how fast and where a drug is absorbed, and it dictates the auxiliary labels applied at dispensing. Route abbreviations appear constantly on prescriptions and in order entry. Mismatching form and route is a common source of error.
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.
Storage, Handling, and Stability
Storage conditions preserve potency and are defined by standard temperature ranges rather than vague terms. Technicians monitor refrigerators, protect light-sensitive products, and secure controlled substances. Dating rules differ between manufactured products and those repackaged or compounded in the pharmacy.
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 RequirementsLight-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 labelingControlled 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 1301.75Expiration 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 and High-Alert Medications
Some drug pairs are confused because their names look or sound similar, and some drugs cause severe harm whenever an error does reach the patient. These two categories drive most of the safeguards built into pharmacy workflow. Technicians are the first line of defense against both.
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 NamesTall 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 ProjectPhysical 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 MedicationsIndependent 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.
Test your knowledge
Practice questions on Medications
Last updated: July 2026