A multiple-choice test contains 10 questions. There are four possible answers for each question.a) In how many ways can a student answer the questions on the test if the student answers every question?________________b) In how many ways can a student answer the questions on the test if the student can leave answers blank?
Exam 1 1. What is the flow rate to be used to infuse 1200 ml of dextrose 5% in water over 4 hours if the set delivers 15 drops per ml a. 25 gtt/min b. 50 gtt/min c. 75 gtt/min d. 90 gtt/min 2. The physician orders cefaclor 450mg tid. The drug is available as a 375mg/5ml suspension. What volume should be given for each dose a. 4 ml b. 6 ml c. 8 ml d. 10 ml 3. What volume of a 4% hydrocortisone solution can be made from 30gm of hydrocortisone powder a. 500 ml b. 750 m1 c. 1000 ml d. 1500 ml 4. How many 200mg tablets would be required to make 1.5 liters of a 1:250 solution a. 30 tablets b. 60 tablets c. 300 tablets d. 600 tablets 5. How many milliliters of a 3% solution need to be used with a 12% solution in preparing 450 ml of a solution containing 7% a. 100 ml b. 125 ml c. 200 ml d. 250 ml 6. The recommended dose of cefadroxil is 30mg/kg/day. What would be the daily dosage for a child who weighs 44 lbs a. 150 mg b. 300 mg c. 450 mg d. 600 mg 7. Vitamin E capsules have a cost of $4.50. The markup at the store is 16%. What is the selling price for the Vit.E a. $5.11 b. $5.22 c. $6.11 d. $6.22 8. A technician has been given 300ml of a 15% hydrochloric acid solution. The pharmacist asks the technician to dilute the solution to 1000ml with sterile water and to label the final solution. What percent should appear on the label a. 3.5% b. 4.5% c. 5.5% d. 6.5% 9. How many teaspoons are in 16 ounces a. 24 teaspoons b. 48 teaspoons c. 72 teaspoons d. 96 teaspoons 10. Convert the following number to Roman numerals: 1139 a. MCXXXIX b. MCCXXIX c. MCMXXXVIII d. MCXXXX 11. Another name for hydrocodone/acetaminophen is: a. Percodan b. Valium c. Vicodin d. Tylenol #3 12. Maintaining a correct count of narcotic supply is an example of: a. Information processing b. Inventory control c. Medication dispensing d. Communication function 13. Divide the following and choose the best answer: 4 2/3 divided by 2/3 = a. 6 2/3 b. 8 c. 7 d. 7 1/3 14. Reduce the following to lowest terms, then choose the best answer: 88/11 = a. 7 2/11 b. 8 c. 6 3/11 d. 8 1/11 15. 75% of what number is 62 a. 59 b. 69 c. 83.8 d. 82.7 16. An over-the-counter drug is: a. Any drug purchased in the pharmacy. b. Medication labeled as DME only. c. The opposite of drugs sold under the counter d. Medication that can be purchased without a prescription. 17. Solve for X in 4.4 : 8.2 :: X : 5.6 a. 3.1 b. 3.8 c. 3.0 d. 3.9 18. The hospital committee that is usually responsible for creating and maintaining the drug formulary is the: a. Nursing and Pharmacy Committee b. Pharmacy and Therapeutics Committee c. Product Evaluation Committee d. Infection Control Council 19. All are benefits of a unit dose distribution system EXCEPT: a. nursing time is virtually eliminated. b. charting of medications is more accurate. c. controlled substances do not have to be accounted for. d. medication errors are dramatically reduced. 20. You have a bottle of Ceclor suspension 125mg/5ml. The dose needed is 425mg. How many ml need to be dispensed a. 19.5 b. 20 c. 17 d. 11 21. You have a vial of Testosterone for injection 200mcg/ml. The dose needed is 275mcg. How many ml will be needed for this dose a. 2.32 b. 1.38 c. 1.83 d. 3.83 22. The term “antitussive” refers to: a. pain relief b. relieve itching c. relieve coughing d. reduce swelling 23. A tablet that has a special coating to prevent dissolution in the stomach so that the tablet will dissolve in the intestines is called: a. caplet b. effervescent c. film coated d. enteric coated 24. Change the following ratio to a percentage: 7 : 92 a. 11% b. 21.8% c. 7.6% d. 8.2% 25. Convert the following to an Arabic number: MMCDLIV a. 2544 b. 2454 c. 2684 d. 2554 26. To dispense an order calling for: Prednisone 5mg i tid X 3 days, i bid X 3 days, 1 qd X 3 days, the total medication needed is: a. 15 tablets b. 18 tablets c. 21 tablets d. 24 tablets 27. Diazepam is considered a: a. generic name b. chemical name c. trade name d. brand name 28. Which of the following statements regarding a drug is NOT correct based on the definition of a drug by the Federal Food, Drug and Cosmetic Act a. A drug is an article recognized in the official United States Pharmacopoeia. b. A drug is an article intended for the diagnosis of disease in man or other animals. c. A drug is an article intended for the cure of disease in man or other animals. d. A drug is an article (including food) intended for affect the structure of any function of the body on man or other animals. 29. The process that brings a drug from the administration site into the blood stream is called: a. absorption b. distribution c. metabolism d. elimination 30. The prescriber’s DEA number is required on a prescription for: a. legend drugs b. OTC drugs c. generic drugs d. controlled substances 31. You have a vial of codeine for injection 60mg/3ml. The dose needed is 7ml. How many mg will be administered a. 0.28 b. 140 c. 280 d. 20 32. You have Decadron liquid available 0.5mg/3ml. The dose needed is 3.7mg. How many ml will be dispensed a. 22.2 b. 18 c. 0.62 d. 6.2 33. Dilaudid is considered a: a. generic name b. chemical name c. common name d. brand name 34. Generically equivalent drugs are: a. chemically identical in strength, concentration, dosage form and route of administration. b. containing different active ingredients. c. priced exactly the same. d. chemically different but expected to produce essentially the same therapeutic outcome and toxicity. 35. When two or more drugs combine to provide a response that is greater than the sum of the individual drugs, it is called: a. an additive effect b. synergism c. potentiation d. plagiarism 36. The federal health insurance provided to people age 65 and over is called: a. Medicaid b. Medicare c. BlueCross Blue Shield d. Managed Care 37. Another name for Tylenol is: a. Ibuprofen b. Ultram c. Pandol d. Excedrin 38. Lisinopril is another name for: a. Calan SR b. Prilosec c. Prinivil d. Claritin 39. All of the following are Schedule II (C2) drugs EXCEPT: a. Demerol b. Duragesic c. Percodan d. Tussionex 40. Which prefix stands for kidney a. Nephro b. Hepato c. Nephra d. Rhino 41. The latin abbreviation for left ear is: a. A.D. b. A.S. c. B.I.D. d. L.E. 42. Which chemical symbol represents potassium a. Fe b. Po c. K d. P 43. If a Pharmacist weighs 178 kg, how many lbs. does this Pharmacist weigh a. 81 b. 198 c. 212 d. 392 44. 22 gr is the same as how many mg a. 1200 b. 1430 c. 1800 d. 1875 45. An antipyretic drug would: a. reduce inflammation b. reduce swelling c. raise heart rate d. reduce fever 46. “PR” written on a prescription would stand for: a. per R.Ph b. per right ear c. per rectum d. per right nostril 47. How many ml of Cefaclor Suspension 125mg/5ml would you need for a 55mg dose a. 1.2 b. 2.0 c. 2.2 d. 2.5 48. Quinapril HCL is the same as: a. Quinaglute b. Accolate c. Quinidex d. Accupril 49. Which of the following is classified as an antifungal a. Septra b. TobraDex c. Zyrtec d. Lotrisone 50. Quinapril HCL is classified as a(n): a. Tranquilizer b. ACE inhibitor c. H2 antagonist d. Ca Channel Blocker 51. Which of the following is NOT a controlled substance a. Hycodan b. Lorcet c. Percogesic d. Prosom 52. What is 20% of 95 a. 15 b. 19 c. 23 d. 25 53. A solution is labeled 1:4000. What is the percentage strength of the solution a. 0.015% b. 0.025% c. 0.25% d. 0.55% 54. Convert 0.3mg to gr. a. 1/100 gr b. 1/150gr c. 1/200gr d. 1/12gr 55. Drug tolerance is best defined as: a. a patient’s decreased response to a different drug. b. a patient’s response to an interaction. c. a patient’s decreased response to the same drug at the same dose. d. a patient’s lack of response to a drug overdose. 56. 10 liters is the same as _____ oz. a. 200 b. 294 c. 333 d. 1000 57. Another name for KCL is: a. Calcium Bromide b. Potassium Chloride c. Kryptite Chloride d. Sodium Chlorine 58. You are given a solution of NaCl = 4mEq/ml. Part of the TPN that the doctor requests is for 50mEq per bag of 1000ml D5W to be dispensed over an 8-hour period. How much of the NaCl solution do you need to make the TPN a. 1.25ml b. 12.5ml c. 20 ml d. 22.5ml 59. The latin abbreviation for “under the tongue” is: a. UT b. SDL c. SC d. SL 60. You have Amoxicillin 250mg/5ml and need to dispense a 200mg dose. How many ml are needed a. 4 b. 5.5 c. 10 d. 20 61. The latin abbreviation for “right eye” is: a. OU b. OD c. OR d. RE 62. Find the correct percent for the following ratio 1:150 a. 0.066% b. 0.66% c. 1.12% d. 1.50% 63. Pharmacology is the study of: a. side effects on the body. b. how drugs interact with the body. c. drug origins from plant sources. d. chemical structures. 64. Medications having no accepted medical use in the United States with the highest abuse potential are classified as: a. Schedule I b. Schedule II c. Schedule III d. Schedule IV 65. The Pharmacy Manager just called the DEA office and local police about stolen Norco tablets. What form should the Pharmacy Manager with the DEA a. DEA Form 41 b. DEA Form 106 c. DEA Form 222 d. DEA Form 208 66. 0.9% NS 1000ml/bag is set to run at 80ml/hr. How many bags will be needed for a 24 hour period a. 1.2 bags b. 1.9 bags c. 2.4 bags d. 3.0 bags 67. An IV is set for Ampicillin 125mg in 100 ml NS administered over 20 minutes every 6 hours. If 15 gtts/ml, how many mg are administered per day a. 450mg b. 475mg c. 500mg d. 550mg 68. All of the following drugs would be ordered on DEA Form 222 EXCEPT: a. Dilaudid b. Methylphenidate c. MSIR d. Valium 69. Levothyroxine sodium is another name for: a. Eythroid b. Diabeta c. Synthroid d. Avonex 70. The generic name for Norvasc is: a. Nortriptyline b. Amidarone c. Amlodipine d. There is no generic 71. PPI means: a. post partum indication b. patient product indication c. patient package insert d. patient/product incident 72. D %W/0.9%NaCl 500 ml to be administered over 6 hours. Determine how many ml will be administered per 5 hour. a. 78 b. 83 c. 73 d. 88 73. For the same problem above (#72), solve for gtts/min. (Assume 60 gtts/ml) a. 78 b. 83 c. 73 d. 88 74. All of the following are corticosteroids used to treat asthma EXCEPT: a. Aerobid b. Azmacort c. Imitrex d. Vanceril 75. You are asked to make 150 ml of a 3% Na Borate solution. Using 5% Na Borate stock solution and water, how much of each do you need a. 80 ml of 3% & 70 ml water b. 90 ml of 5% & 60ml water c. 60 ml 5% & 90 ml water d. 85 ml of 5% & 65ml water 76. Convert the following to Celsius: 212°F a. 90 b. 100 c. 95 d. 118 77. Convert the following to Fahrenheit: 20°C a. 58 b. 60 c. 68 d. 78 78. Using Young’s Rule, calculate the number of mg needed of labetolol 200 mg tid for a patient who is 4 years old and weighs 35 lbs. a. 45 mg b. 50 mg c. 55 mg d. 60 mg 79. Use Clark’s Rule to calculate the same problem above (#78). a. 38 mg b. 45 mg c. 47 mg d. 55 mg 80. How many grams of 2.5% lidocaine jelly should be mixed with 360gm of 0.25% lidocaine jelly to make a 1% jelly a. 120 gm b. 130 gm c. 160 gm d. 180 gm 81. If 6 ml of phenol are added to 200 ml of lotion, what is the percentage (v/v) of phenol in the lotion a. 1% b. 2% c. 3% d. 4% 82. A drug that causes a narrowing of the blood vessels is called a: a. emetic b. pruritic c. vasoconstrictor d. vasodilator 83. Which of the following medications is a tricyclic antidepressant a. amitriptyline b. fluoxetine c. metoprolol d. thioridazine 84. Which of the following may reduce the absorption of tetracyclines when given together a. antacids b. iron c. dairy products d. all of these 85. Which of the following is a triphasic oral contraceptive a. Loestrin b. Desogen c. Ovcon d. Triphasil 86. Which of the following insulin is classified as short acting a. Regular b. Lente c. Ultralente d. NPH 87. Which of the following is a stimulant laxative a. Bisacodyl b. Docusate Sodium c. Glycerin d. Mineral Oil 88. Convert 55 kg to lbs. a. 105 b. 111 c. 98 d. 121 89. An elixir of KCL contains 20mEq/5ml. Calculate the number of ml needed for a 12 day supply if the patient takes 40mEq per day. a. 100 b. 120 c. 140 d. 180 90. A prescription for Digoxin 0.25mg retails for $5.99. What is the cost of the medication if the gross profit is 55% a. $2.70 b. $3.87 c. $1.88 d. $2.99 91. The term “cost” can be defined as: a. what the customer pays b. the cost to the manufacturer c. the invoice amount to the pharmacy d. the invoice amount to the manufacturer 92. Gemfibrozil is the generic name for: a. Lescol b. Questran c. Lopid d. Zocor 93. Covert from Celsius to Fahrenheit: 17°C = °F a. 52.6 b. 62.6 c. 58.4 d. 60.0 94. The drug of choice to treat children for fever or flu-like symptoms is: a. Acetaminophen b. Aspirin c. St. Joes d. Ibuprofen 95. Arnie weighs 205 lbs. How many kgs does Arnie weigh a. 85 b. 103 c. 93 d. 89 96. Tablets held in the mouth for slow dissolution are called: a. effervescents b. lozenges c. matrix tablets d. pellets 97. In what proportion should 10% ethanol be mixed with 65% ethanol to obtain 50% ethanol a. 9/10 of 10% and 1/10 of 65% b. 8/11 of 65% and 3/11 of 10% c. 1/11 of 65% and 10/11 of 10% d. 2/3 of 65% and 1/3 of 10% 98. Verapamil is the generic for all of the following EXCEPT: a. Calan b. Cardizem c. Isoptin d. Verelan 99. Tobramycin injection is given in D5W/50ml as 250mg over 20 minutes every 8 hours. How many mg are administered on a daily basis a. 600 b. 650 c. 700 d. 750 100. How many gtts/min should be given for the above problem (#99). (Assume 15gtts/ml) a. 37.5 b. 40 c. 42.5 d. 45 101. A pharmacy receives an order for 320ml of a 6% sodium borate solution. How many ml of sodium borate are needed to make the solution a. 18.8 b. 19.2 c. 19.8 d. 20.2 102. A pharmacist has weighed out 12gm of Ibuprofen and has given it to you with instructions to compound a 3% ointment. What will be the final weight of the prescription a. 500 gm b. 400 gm c. 400 mg d. 500 mg 103. If you were given a TPN order to have CaGluconate 30 mEq, how many ml would you prepare if you were given a vial of 0.6 mEq/ml CaGluconate a. 40 ml b. 45 ml c. 50 ml d. 55 ml 104. If there is a theft of a controlled substance in the pharmacy, what does the pharmacist have to do to report it a. Notify the nearest DEA Office b. Call the local police c. Complete a DEA form 106 and send original to the DEA and retain a copy in the pharmacy. d. All of the above 105. Depreciation is the: a. total amount of money received for a service. b. amount of money left over from the selling price. c. the loss of value of an item over a period of time. d. itemized list of merchandise. 106. ISS gr = ________ mg a. 120 mg b. 122 mg c. 88 mg d. 94 mg 107. An order is written for Digoxin 0.375. You have a vial of 0.5 mg/2 ml Digoxin in stock. How many ml are needed a. 1.5 ml b. 1.95 ml c. 2.0 ml d. 2.5 ml 108. Which of the following requires a special DEA form when ordering a. Class II controlled substances b. Class III controlled substances c. Class IV controlled substances d. All of these 109. The government agency that regulates and monitors the pharmaceutical industry is the: a. AMA b. APhA c. DEA d. FDA 110. The average adult dose of amoxicillin is 1500mg tid. Using Young’s Rule, calculate the dosage of amoxicillin needed for a 4-year old child who weighs 50lbs. a. 50 mg b. 75 mg c. 125 mg d. 167 mg 111. Using the information from the question above (#110), calculate the needed dosage using Clark’s Rule. a. 50 mg b. 75 mg c. 125 mg d. 167 mg 112. Convert 25°C to F. a. 77 b. -4 c. 68 d. 30 113. Convert 32°F to C. a. -10 b. 0 c. 22 d. 64 114. Ginseng sells for $5.99. Our cost is $2.75. What is the markup for this product a. $2.75 b. $2.99 c. $3.15 d. $3.24 115. Calculate the amount of markup for a bedpan with a cost of $3.50 and markup of 65%. a. $1.82 b. $1.85 c. $2.28 d. $2.25 116. Calculate the selling price for the item above. a. $4.99 b. $4.19 c. $5.78 d. $5.12 117. The following DEA number is valid: AB2174567 a. True b. False 118. Carisoprodol is the generic name for: a. Carafate b. Ceftin c. Senokot d. Soma 119. How many 400mg etodolac tablets will be needed to make 12 ounces of 18% solution a. 182 b. 202 c. 188 d. 162 120. A generic brand of Centrum sells for $7.99. The net profit is $3.50 and the overhead is $1.00. What is the cost a. $2.79 b. $2.99 c. $3.19 d. $3.49 121. How many 10 mg Lasix tablets are needed to make 240 ml of a 0.2% Lasix suspension a. 28 b 38 c. 48 d. 58 122. Pseudoephedrine is another name for: a. Etodolac b. Entex c. Sudafed d. Tavist 123. A patient weighs 185 lbs, what is the patient’s weight in kg a. 75 b. 84 c. 92.5 d. 407 For Questions 124 & 125: The patient in question #123 is given medication for test anxiety, Inderal. The dose the doctor ordered is 0.24mg/kg. This should be given 2 hours prior to an exam. Inderal stock on your shelf today is in 10mg, 20 mg, 40mg, and 60mg tablets. 124. What is the proper dose of Inderal for the patient a. 20mg b. 40mg c. 60mg d. 140mg 125. How many tablets of Inderal need to be dispensed to this patient in question 124 a. 2 (20mg) tablets b. 1 (20mg) tablet c. 3 (10mg) tablets d. 1 (60mg) tablets 126. Cephalexin suspension is supplied in 125mg/5m1. A doctor order is written for a child to receive 225mg per dose. How many ml will the child receive per dose a. 5 ml b. 9 ml c. 13 ml d. 15 ml 127. The pharmacy receives a prescription for 2 oz of 2% hydrocortisone ointment. You stock a 1% and a 2.5% hydrocortisone ointment. How much of each is needed a. 40 g of 1% and 20 g of 2.5% b. 35 g of 2.5% and 25 g of 1% c. 40 g of 2.5% and 20 g of 1% d. 40 g of 2.5% and 40 g of 1% 128. Which of the following is a valid DEA prescriber registration number a. AB2453161 b. AB2453162 c. AB2453163 d. AB2453619 129. If a medication’s expiration date is 7/16, when will it expire a. midnight 6/30/16 b. start of the day 7/16/current year c. midnight 7/1/2016 d. midnight 7/31/2016 130. What is the correct procedure upon discovering the expiration date has been exceeded on a medication a. Re-label with a new expiration date 6 months from the current date b. Remove from active stock for proper disposal c. Rotate the medication to the front of the shelf so that it will be used first d. Dispense without a fee 131. The following is a valid DEA number for Dr. Jeffrey Babalon: BJ3892040 a) True b) False 132. OBRA 90 requirements for counseling include the provision of information on the following: a) patient self-monitoring techniques b) storage requirements c) cost of the medication d) both a and b 133. The following are all examples of a pharmacy technician’s duties except: a) handles returns and documents procedures for credit b) bills co-pay correctly c) transfers prescriptions from another pharmacy d) maintains on-going inventory of controlled drugs 134. Every pharmacy is required to inventory their controlled substances every _________ and kept on file for ________. a) 2 years, 2 years b) 3 years, 3 years c) 2 years, 3 years d) 1 year, 7 years 135. The following are requirements of a repacking log book except: a) expiration date of manufacturer b) lot number of medication c) size of vial d) date of repackaging 136. Diazepam is an example of a: a) CII b) CIII c) CIV d) CV 137. All of the following are federal laws that affect the practice of pharmacy except: a) Controlled Substances Act b) Food, Drug, and Cosmetic Act c) Safe Generic Drug Act d) Omnibus Reconciliation Act 138. A Class I recall is: a) where exposure to the product may cause reversible health hazards b) where exposure to the medication will not cause adverse health hazards c) where exposure to the product will cause severe health hazards/death d) both a and b 139. Federal law requires that the patient’s address be included on the prescription label of a controlled substance. a) True b) False 140. Exemptions to the Poison Prevention Packaging Act do not include: A) nitroglycerin tablets B) oral contraceptives C) schedule V drugs D) All of the above are exempt 141. Which of the following requires a PPI: a) Estropipate b) Serevent c) Premarin d) Accutane e) All of the above 142. Which of the following is responsible for separating drugs into 2 categories: a) Occupational and Safety Act of 1970 b) Food, Drug, and Cosmetic Act of 1906 c) Durham-Humphrey Amendment d) Kefauver-Harris Amendment 143. All the following are true about the Poison Prevention Packaging Act (PPPA) except: a) enacted to try and reduce accidental poisonings in children. b) prescriptions dispensed by a pharmacy must be done in a child resistant containers c) only people over 12 years of age are able to open the container d) medications that are labeled “package not child resistant” are exempt from this legislation. 144. Which of the following standardized labeling requirements for the manufacturer and dispenser to the patients a) Durham-Humphrey Amendment b) CSA c) DEA d) Kefauver-Harris Amendment 145. Which of the following is not required on a controlled substance prescription a) Date b) Doctors signature c) Lot number d) DEA number 146. Which medication requires a “cover” prescription a) Ecotrin b) Lopressor c) Vicodin d) Provera Answers to Exam 1 You must have 75% to pass. 1. C 51. C 101. B 2. B 52. B 102. B 3. B 53. B 103. C 4. A 54. C 104. D 5. D 55. C 105. C 6. D 56. C 106. D 7. B 57. B 107. A 8. B 58. B 108. A 9. D 59. D 109. D 10. A 60. A 110. C 11. C 61. B 111. D 12. B 62. B 112. A 13. C 63. B 113. B 14. B 64. A 114. D 15. D 65. B 115. C 16. D 66. B 116. C 17. C 67. C 117. B 18. B 68. D 118. D 19. C 69. C 119. D 20. C 70. C 120. D 21. B 71. C 121. C 22. C 72. B 122. C 23. D 73. B 123. B 24. C 74. C 124. A 25. B 75. B 125. B 26. B 76. B 126. B 27. A 77. C 127. C 28. D 78. B 128. D 29. A 79. C 129. D 30. D 80. A 130. B 31. B 81. C 131. B 32. A 82. C 132. D 33. D 83. A 133. C 34. A 84. D 134. A 35. B 85. D 135. C 36. B 86. A 136. C 37. C 87. A 137. C 38. C 88. D 138. C 39. D 89. B 139. A 40. A 90. A 140. C 41. B 91. C 141. E 42. C 92. C 142. C 43. D 93. B 143. C 44. B 94. A 144. D 45. D 95. C 145. C 46. C 96. B 146. C 47. C 97. B 48. D 98. B 49. D 99. D 50. B 100. A Get Trained Fast 2008 CopHome UsDawn LaLiberte RPh PTCB Study Manual For Pharmacy Technicians 1 PHARMACY TECHNICIAN CERTIFICATION EXAMINATION CONTENT OUTLINE......... I. Assisting the Pharmacist in Serving Patients: 66% of Examination Includes activities related to traditional pharmacy prescription dispensing and medication distribution. 1. Receive a hardcopy prescription/medication order from patient/patient’s representative, prescriber, or other healthcare professionals. 2. Under supervision of the pharmacist, assist in obtaining from the patient/patient’s representative such information as diagnosis or desired therapeutic outcome, medication use, allergies, adverse reactions, medical history, psychosocial history, visual impairment, physical disability, and reimbursement mechanisms. 3. Assess prescription/medication order for completeness, correctness, authenticity, and legality. 4. Under supervision of the pharmacist, assist in obtaining from prescriber and/or other health care professionals important information 5. Update the medical record/patient profile with medication history, allergies, medication duplication, and/or drug- disease, drug-drug, drug-laboratory interactions. 6. Process the prescription/medication order 7. Storing and delivering medication to patient/patient’s representative 8. Determine third-party charges. 9. Provide supplemental information (e.g. patient package inserts, computer information and videos) II. Medication Distribution and Inventory Control Systems: 22% of Examination Includes activities related to medication and supply purchasing, inventory control, and preparation and distribution of medications according to approved policies and procedures. 1. Place orders for pharmaceuticals, durable medical equipment, devices, and supplies 2. Receive goods and verify specifications on original purchase orders 3. Place pharmaceuticals, durable medical equipment, devices, and supplies in inventory under proper storage conditions 4. Remove from inventory expired/discontinued/slow-moving pharmaceuticals, durable medical equipment, devices, and supplies, and document actions taken 5. Recalls and document actions taken 6. Identify supplies to be ordered (i.e. “want book”) 7. Communicate changes in product availability (i.e. formulary changes, recalls) 8. Maintain policies and procedures to deter theft and/or drug diversion 9. Maintain a record of controlled substances received, stored, and removed from inventory 10. Maintain recordkeeping systems for repackaging, recalls, and returns of supplies 11. Compound medications in anticipation of prescriptions/medication orders (i.e. bulk compounding) 12. Prepackage finished dosage forms for dispensing 13. Collect and analyze data on the quality of pharmacy products and services III. Operations: 12% of Examination Includes activities related to the administrative processes for the pharmacy practice. 1. Coordinate communications throughout the practice center and/or service area 2. Participate in meetings to obtain feedback regarding the performance in the practice center 3. Monitor for compliance with federal, state, and local laws, regulations, and professional standards 4. Implement and monitor policies and procedures for sanitation, hazardous waste handling, and infection control 5. Perform and record routine sanitation, maintenance, and calibration of equipment 6. Maintain a manual or computer based information system Copyright 2007 V1V2 2 Are You Ready Checklist To Do □ Complete registration with PTCB and pick a test date. □ Purchase Study Material □ Study Manual □ Math Workbook □ Advanced Math Problems □ Practice Exams □ What are the differences between a Prescription and a Medication Order □ Why is a Patient Profile important to complete □ When do you know when to refer a patient to a pharmacist □ Latin Abbreviations □ Absorption, Distribution, Metabolism, Elimination definitions □ Dosage forms □ NDCs □ Expiration Dates □ Unit doses □ Fractions, Decimals, and Roman Numerals □ Conversions □ Alligations □ Celsius and Fahrenheit □ Flow Rates □ Weights that Class A,B and Analytical balances can weigh accurately □ Types of Mortars and what each is for □ Definitions of Levigation, Trituration, Punch Method □ Differences between Conical and graduated Cylinders and how to measure □ Antibiotics □ Cardiovasculars □ GI Meds □ Respiratory Meds □ Diabetes □ Analgesics □ Blood Disorder Meds □ Psychotherapeutic Meds □ Hormones □ HIV/AIDS □ Topicals □ Auxiliary Labels □ Aseptic Technique’s dos and don’ts □ How to clean □ How to correctly operate □ Differences between Horizontal and Vertical Flowhoods □ Where the filter is located □ Direction of airflow □ Which one to use with hazardous materials □ Syringes/Needles – Names and critical sites □ Differences between vials and ampoules □ IVs and Injections 3 □ TPNs □ Antineoplastics □ Distribution and Inventory □ Identify Robotic names □ Formulary System □ Inventory Systems □ Purchasing Choices □ Returns □ Drug Recalls □ Computer Terminology □ Law □ FDA Regulates who □ Durham-Humphrey □ Kefauver-Harris □ PPIs □ Poison Prevention Packaging Act □ Occupational and Safety Act □ Poison Log Requirements □ Controlled Substance Act □ DEA Identification □ Amount of Refills allowed □ Limitations of Pharmacy Technician □ Repackaging Requirements □ OBRA □ DEA Forms □ Classroom Quiz 1 and 2 □ Review Past Exam Questions □ Q&As □ Math Workbook □ Advanced Math Problems □ Practice Exams 1,2,3,and 4 □ Get a good nights sleep □ Bring pencils and a non-programmable calculator □ Also use the syllabus as a checklist □ ____________________________________________________________ □ ____________________________________________________________ □ ____________________________________________________________ □ ____________________________________________________________ □ ____________________________________________________________ 4 “What is the definition of a prescription” A prescription is an order for a medication issued by a licensed medical practitioner. For example: Physician, dentist, veterinarian, podiatrist, physician assistant, and nurse practitioner. A prescription is required if the medicine requires medical supervision. The drug is unsafe without medical supervision. A prescription medication is required by the manufacturer to print on the stock bottle: “Caution, Federal Law prohibits dispensing without a prescription.” A prescription may come in different forms: - Written form from the office - The office may telephone in the prescription (Only RPhs and Interns are allowed to take) No CIIs - The office is allowed to fax in the prescription (with an exception: CIIs) - The office may transmit through the computer (electronic prescriptions) NO CIIs A prescription is different from a medication order in that: A prescription is an order given to the patient to have filled and a medication order is medications written by the physician in an institution (hospital) and kept on one sheet of paper in the patients file for the whole hospital staff to use. See examples. Technicians may do refill requests. They must provide the following information to the doctor’s office: 1. Pharmacy name and Phone Number 2. Patient name and Date of Birth 3. Drug Name, Strength, and Quantity 4. Directions to confirm no change 5. Date of the last refill Patients may come to the pharmacy with seemingly simple problems while in reality the problem is complex, possibly life-threatening. For example, a patient may ask for a recommendation for a headache. The appropriate response from the technician is to refer the patient to the pharmacist. “Why can’t you just tell them to take aspirin” Because the patient may be on another medication like coumadin that aspirin interacts with. Pharmacists are trained to INTERVIEW patients and determine if it might be and indication of a more serious medical condition. As a guideline, a technician should recognize that questions that have only ONE FACTUAL (exact) answer may be answered by the technician. ie. “What is the brand name of warfarin” The technician can answer, “Coumadin”. If the technician were to look up the answer in a book it will only have one answer for this question therefore the technician may answer. BUT, if the question was, “What is the use of propranolol” This should be answered by the R.Ph. because there are many uses and will prevent any miscommunication and inaccurate information given. 5 ASSESSING ORDER COMPLETENESS Elements of a Prescription Every medication order and prescription should contain the following elements: • Patients name • Name of drug (generic or brand) • Route of Administration • Dosage form - Only required if the medicine comes in more than one form • Dose • Strength - Only required if the medicine has more than one strength available • Quantity and frequency of administration • Prescriber’s name and signature • Prescriber’s Drug Enforcement Agency (DEA) number – for controlled substances only • Date written • Refill information Additional information that is included on inpatient orders (hospital) includes: • Rate or time of administration • Allergy information • Account number • Admission number • Room and bed location • Time of day written • Diagnosis • Patients diet • Indication for use of the medication Labeling Medications Prescription Label Requirements Under the Food, Drug, and Cosmetic Act (FDCA), the prescription label must have the following information: • Name and address of the pharmacy • Serial number of the prescription (Rx number) • Date of the prescription or its date of filling or refilling • Name of the prescriber • Name of the patient • Directions for use State law may further require the following: • Address of the patient • Initials or name of the dispensing pharmacist • Telephone number of the pharmacy • Drug name, strength, and manufacturer’s lot or control number • Expiration date of the drug • Name of the manufacturer • Amount of the drug dispensed • Refill information 6 Elements of a Label Draw your own label. Place all the requirements of a prescription label from memory. If the medication is a controlled substance, the label must state, “Caution, Federal Law prohibits the transfer of this drug to any person other than the patient for whom it was presDO NOT COVER THIS UP WITH AN AUXILARY LABEL. “Who regulates what goes on a prescription label” Answer: FDA FDA Requirements: 1. Name of Pharmacy 2. Address of the Pharmacy 3. Rx Number 4. Date of filling 5. Name of the Patient 6. Directions of Use 7. Address of the Patient 8. Initials of dispensing Pharmacist 9. Phone number of Pharmacy 10. Drug Name, Strength, Form, and Quantity 11. Expiration Date 12. Manufacturer 13. Refill Information 7 Elements of a Prescription Label all the requirements of a prescription. Draw your own prescription with the following information. Draw your own prescription with all requirements. DAW must be handwritten on the script for the pharmacist to only dispense the brand medication only. If this is not on the prescription, then you are allowed to ask the patient if they would like the generic version of the medication for a cost savings. And dispense the generic. Legend drugs: PRN refills are good for one year. C3-C5 drugs: PRN refills are good for 6 months. The original prescription plus 5 more is the maximum that the doctor can write for. C2 drugs: NO REFILLS ALLOWED. Even if a doctor accidently writes in refills. If the refill line is left blank this is the same as zero refills. 1. Patients name 2. Name of Drug 3. Route of Administration – If the route is missing, the patient might not take it as you assume. 4. Dosage Form- only needed if the drug comes in more than one form. 5. Dose 6. Strength – Only needed if the drug comes in more than one strength. 7. Quantity 8. Prescriber’s name printed on the prescription 9. Prescriber’s signature 10. Date written 11. Refill information – if the refill spot is blank then a zero must be placed on the label. 12. DEA number of the prescriber – only needed if the medication is a controlled substance. 8 Example of a Medication Order Take notice that ALL information is on this one sheet. This is a medication order in an institution (hospital). Diagnosis (Dx), condition of patient, allergies, diet, and medications. Times and room numbers are important in a hospital. 9 Patient Profiles A patient profile includes a list of all the prescriptions received by a patient and all of the corresponding prescription information (e.g. original date, refill dates, doctor information). Active medications should be listed first, and they should be separated from the discontinued medications. Also, O-T-C medications should also be listed for the pharmacist to monitor interactions. The following information is usually found in a patient profile: • Patient name and identification number • Date of birth or age • Sex • Height and weight - hospital use • Diagnosis or health conditions • Name of parent or guardian • Patient address and phone number . • Names of practitioners (e.g. physicians, dentists, podiatrists) • Medication allergies • Third-party payer information • Medication history (current, old, and OTC) • Special considerations (foreign language) • Clinical comments (e.g. therapeutic monitoring, counseling notes) • Desired therapeutic outcome – what does the doctor hope to accomplish Referring Patients to a Pharmacist It is very important for technicians to know when to answer a patient’s question and when to refer the patient to the pharmacist. Technicians SHOULD NOT interpret a patient-specific question or provide information that may require professional judgment. The technician is not the one to tell the patient that they need to see a doctor…..that is the pharmacist’s job. There are three reasons why technicians should always refer patients with drug (even OTCs) or health-related questions to a pharmacist: 1. Drug-Drug Interactions The patient may be taking prescription or other nonprescription drugs that may interact with OTC medication. For example, drugs used for heartburn and acid indigestion interact with heart disease, blood pressure, and seizure disorders. Aspirin and Coumadin (warfarin) interact and could cause internal bleeding. This is important to remember. 2. Drug-Disease State Interactions Some nonprescription drugs may worsen the patient’s existing disease state. Sudafed (pseudoephedrine) worsens high blood pressure and diabetes therefore should not be taken. Important 3. Drug-Food Interactions The absorption of ketoconazole and nitrofurantion increases when taken with fatty foods. The absorption of Tetracycline, Cipro, Phenytoin decreases when taken with any food. Grapefruit interacts with Calcium Channel Blockers and estrogens. Warfarin interacts with food high in Vitamin K (spinach and romaine) 4. Need for Physician Referral Pharmacists have their limits. The pharmacists are the ones with the knowledge of knowing when the condition requires medical attention. 10 11 Common Latin Abbreviations You only need to memorize these to pass the exam. Make flashcards. Abbreviation Meaning a before– latin for ante like a.m. is before noon aa of each ac before meals – again ante means before ad right ear as left ear To remember between ear and eye: am before noon Ear has an A in the spelling and the au both ears latin abbreviation is a.d., a.s. or a.u. bid twice daily Eye is opthlamic and the latin c with abbreviation is o.d., o.s., or o.u. d give dtd give such doses D = means right (dextro in latin). I’m f,ft. make right handed, so my right hand is dextro. I label my right hand “D”. gtt drop gtts drops S = means left (sinister in latin). My h hour left hand is weaker or bad so it is sinister. I label my left hand “S”. hs at bedtime i, ii, iii, iv, v 1,2,3,4,5 M mix U = means both. I picture a referee in football holding both arms in the air Mft. mix and make for a touchdown. You need BOTH to noct night complete the signal. non rep, NIR no refills od right eye os left eye To remember between bid, tid, or qid: ou both eyes p after bid = bi means two like in bicycle PC after meals tid = ti means three like in tricycle po by mouth pm after noon qid = means four or quad like in a four pr rectally wheeler prn as needed q every qd every day qod every other day q2h every 2 hours q4h every 4 hours qid four times daily qs quantity sufficient sl sublingual (under the tongue) ss 1/2 sig directions stat now tid 3 times daily Ut dict , ud, utd as directed 12 Write out the following directions in a complete sentence. i gtt ou bid x 7 d i appl vag qhs i tab po qid pc iss tsp po tid prn cough iv gtts ad q 4 h prn pain i cap po tid ac + hs i tab sl prn chest pain ii tab po qod ii stat, i tab qid x 10 d i supp pr q 6 h prn nausea i – ii caps po q 4-6 h prn p How many tablets should be dispensed for a 30 day supply i tab qid x 1 day, i tab tid x 2 days, i tab bid x 3 days, then i tab qd thereafter. Answers: Insert one drop into both eyes twice daily for 7 days. , Insert one applicatorful vaginally every night at bedtime. , Take one tablet by mouth four times a day after a meal. , Take one and one-half teaspoonful by mouth 3 times a day as needed for cough. , Insert 4 drops into right ear evry 4 hours as needed for pain. , Take one capsule by mouth three times a day before a meal and again at bedtime. , Dissolve one tablet under the tongue as needed for chest pain. , Take two tablets by mouth every other day. , Take two tablets immediately then one tablet four times a day for 10 days. , Insert one suppository rectally every 6 hours as needed for nausea. , Take one or two capsules by mouth every 4 to 6 hours as needed for pain. , (1x4x1) + (1x3x2) + (1x2x3) = 16 tablets in 6 days, that leaves 24 days left in the month at taking one tablet once a day to be an additional 24 tablets added to 16 tablets = 40 tablets in 30 days. Memorize the following Definitions Absorption- Drug gets absorbed into the bloodstream Distribution- Drug goes to where it is needed Metabolism - Drug is broken down by the liver Elimination- Excretion from the body 13 Dosage Forms Solid Dosage Forms A. Tablets 1) Most popular dosage form 2) Prepared by mechanical compression 3) Dissolution= must be dissolved in the stomach before it can elicit its pharmacological effect- so this means that it will have the slowest absorption. B. Chewable tablets 1) chewed and dissolved in the mouth prior to swallowing 2) they also can be swallowed whole C. Enteric-coated tablets - Important - has shown up on many tests 1) special coating over tablet to prevent the dissolution within the stomach. 2) these tablets are meant to dissolve in the intestines only. 3) should NEVER be chewed, broken or crushed prior to ingestion. 4) not to be taken with antacids which cause dissolution in the stomach D. Sublingual tablets - Has shown up on many tests 1) placed “under the tongue” where the active ingredient is quickly absorbed into the bloodstream ---absorption is not in the GI tractthis form is faster absorbed than tablets 2) avoids the “first pass” effect - this is where the drug circulates throughout the body before it is broken down in the liver (metabolized) E. Buccal tablets 1) “between cheek and gum” 2) drug is dissolved slowly over a period of time F. Film-coated tablets - Important Biaxin and Depakote are examples. 1) special coating that masks the objectionable odor or taste 2) prevents deterioration due to light and air G. Sustained, timed-release tablets 1) active ingredient is released at a constant rate for a prolonged period of time 2) “long-acting”, “delayed-release”, “prolonged-action” H. Lozenges 1) “troches or pastilles” 2) meant to dissolve slowly in the mouth to keep the drug in contact with the mouth or throat longer I. Pellets 1) cylinder shaped tablets for implantation just under the skin for continuous drug absorption J. Capsules - Will be on the test 1) drug is enclosed within a gelatin shell. 2) after 10 to 30 minutes with the stomach, the gelatin capsule dissolves and the drug is released 3) eliminates bad tastes and odors of drugs K. Effervescent tablets 1) active ingredient + sodium bicarbonate +citric acid (or tartaric acid) acid/base reaction causes a release of carbon dioxide gas = effervescence 2) masks the taste of unpleasant, salty, or bitterness of medication 14 Syrups- = Think SUGAR High concentrations of sugar hinders bacteria growth. Examples: antibiotics, cough preparations Solutions (Soln) – drug is uniformly dispersed throughout the liquid. (it doesn’t settle to the bottom) Therefore there is no need for a shake well sticker. If you hold the liquid up to the light you will not see any drug floating around. Example: Albuterol Solution Suspensions (Susp)- The medication is insoluble in the liquid. (does not dissolve) If you hold this liquid up to the light you will see little particles floating around and then settle. These medications require a shake well sticker because the medication settles at the bottom and the patient will not get the correct dose if not shaken. Example: Bactrim Suspension Elixer- sweetened water with alcohol. If the medication is an elixir, it contains alcohol. Not for babies. Tinctures- highest concentration of alcohol. This has been on past exams National Drug Code (NDC)- Every prescription medication has this. It is devised of 3 sets of numbers. 1. The first set of numbers refers to - the manufacturer and is usually 5 numbers 2. The second set of numbers refers to – the drug name and strength and is usually 4 numbers so 5 : 4 : 2 3. The last set of numbers refers to what – the package size and is usually 2 numbers. For example: 00535-0934-05 This will be on the test. Expiration Dates- All medication has an expiration date. If the medication expires on 11-09 then the exact time it will expire is the last day of the month at midnight. So, in this case this medication expires on November 30 , th 2009 at midnight. 50% Rule: The repackaged vial or unit dose must have an expiration date placed on it; but it is not the same expiration date as what is on the stock bottle. You must take the date on the stock bottle and write the half way date between today’s date and the expiration date. But if the expiration date on the stock bottle is years and years, there is a max of one year that you write on the repackaged item. Unit dose: Medication is dispensed in single unit packages in sealed, sanitary, ready-to-administer doses. Only a 24 hour supply is dispensed in the hospital. “Why” Because of these Advantages: 1. Medication errors reduced 2. Control over medication is increased 3. Drug waste is minimized. Drug can be returned to stock if not used. 4. Less preparation time. 5. Billing is more accurate for the patient. The patient only pays for what was used. Labeling requirements for Unit Dose: 1. Drug name, strength, dosage form 2. Lot number (in case of recalls) 3. Expiration date 4. Directions 5. Auxiliary labels 6. Storage and cautions 7. Manufacturer 8. Repackaging date 15 Fractions to Decimals Reducing fractions to lowest terms Find the largest number that can be divided evenly into both the numerator and denominator. Large fractions may need to be reduced several times. Example 1: Reduce 15 Divide both top and bottom by 3 which would equal 5/8 24 Example 2: Reduce 189 Divide both top and bottom by 3 to equal 63/72 which can be reduced 216 again by dividing by 9 to equal 7/8 Example 3: Reduce 3 Divide both top and bottom by 3 to equal 1/5 15 If you have purchased either Math Workbook, now is the time to turn to page 2 and 3 of the Math Workbook for more practice. Convert a mixed fraction to an improper fraction Multiply the whole number by the denominator and then add the numerator. This number becomes the numerator and is placed over the stated denominator. example: 2 3/5 = 2 x 5 + 3 = 13/5 Now you are able to convert to a decimal form. 5 Rounding decimals: There is no great Changing fractions to decimals importance if the decimal is carried out Divide the numerator by the denominator. one or two places. Just get to the closest answer. The longer you keep the example: 1/4 = 0.25 or 13/5 = 2.6 decimal and keep going on the math Changing decimals to fractions problem, the more accurate the answer will be. The denominator will be either 10 or a multiple of 10. example: “tenths”= one digit to the right of the decimal point 0.7 = 7/10 “hundredths” = .27 = 27/100 x digits to the right of the decimal point = 0.008 = 8/1000 , 0.0365 = 365/10,000 If you have either of the Math Workbooks, do page 4 in either A Practice Problems Math Workbook for more practice. A patient receives the following doses of a certain drug: 1/4 gr., 1/12 gr., 1/8 gr. and 1/6 gr. Calculate the total amount of the drug received by the patient. ¼ = .25 1/12 = 0.0831/8 = 0.125 1/6 = 0.1666 all added together = 5/8 gr or 0.625gr The dose of a drug is 1/60 gr. How many doses can be made from 1/5 gr. 0.2 divided by 0.166 = 12 For more practice do pages 5-11 of Math Workbook. Then come back to this manual and start drug review, start on page 44. Then come back to page 17 and proceed with Roman Numerals. YOU DO NOT NEED THE MATH WORKBOOK TO PASS THE EXAM. IT IS FOR EXTRA PRACTICE AND I HAVE TO TELL YOU WHEN TO GO TO THE BOOK. 16 Roman Numerals Prescribers still sometimes use Roman numerals when writing prescriptions in the: 1) Strength of medication 2) Quantity of drug 3) Amount of drug to take in the sig ss ½ Do these Roman I 1 Numerals along with pages 12-14 in either V 5 of the Math Workbooks if you X 10 L 50 have them. C 100 D 500 M 1000 When a smaller number is before a larger number, then the smaller number is subtracted from the larger. Example 1: CM = 900 M is the larger number and C is the smaller number therefore it is 1000-100= 900. Example 2: XL = 40 X is the smaller number and it is left of L, therefore it is 50 – 10 = 40. Never subtract more than one numeral. When a smaller number is after a larger number, the smaller number is added to the larger number. Example 1: VIII = 8 V = 5 and III = 3 therefore 5+3=8 This is not portrayed as IIX because you cannot subtract more than one numeral. Example 2: LX = 60 which is 50 + 10 When a numeral is repeated, its value is repeated and added together. Example 1: XX = 10+10 Example 2: XXX = 10 + 10 + 10 = 30 Numerals may never be repeated more than three times in a row. So you will never see XXXX = 40 because 40 is XL. When the roman numeral is quite long, you will be adding and subtracting from beginning to end. Example 1: 1998 = MCMXCVIII M = 1000 CM = 1000-100 = 900 XC= 100-10=90 VIII = 8 CDXII = ___________________ 669 = ______________________ CCCXXX=_________________ 2345=______________________ MMVII=___________________ 874 = ______________________ CMLXXIII=________________ 399 = ______________________ Answers: 412, 330, 2007, 973 Answers: DCLXIX, MMCCCXLV, DCCCLXXIV, CCCXCIX 17 If you have purchased either Math Workbook, do pages 7-11. Then come back to this page to get introduced to conversions. Do not get really into conversions until next study time. This will give you a break and not get overloaded. So, review slightly the next 2 pages and then break. Conversions 4ml = 1 dram = 60 grains You will notice a slight difference 5ml = 1 teaspoon between Apothecary and 15ml = 3 teaspoons = 1 Tablespoon = 4 drams Household Measurements. 30 ml = 1 ounce = 8 drams For instance, 30 gm = 1 ounce = 8 drams one pint in Apothecary is 473ml and in 1 cup = 8 ounces Household one pint is 480ml. 1 pint = 2 cups = 16 ounces = 480 ml Same for gallon, which can be 1 quart = 2 pints = 32 ounces either 3840ml or 3785ml. 1 gallon = 4 quarts = 3840 ml If in doubt, use the Apothecary. 1 kg = 2.2 pounds (lbs) 30 mg = 0.5 grains Commit these conversions to memory. It is a good idea to make flash cards of these to help. If you know just these conversions, you will be able to do any conversion on the test. Do not try and remember every conversion you come in counter with. Just memorize the bare minimum and you will retain more. Grains will never produce the exact answer in the book due to grains being a range of numbers during conversion instead of an exact number. For example, 1 grain = a range of 60 – 65mg. Nothing exact. So depending on which number you use, the answer will be different. But the answers on the test will be far enough apart that you will be able to choose your answer. This is very important. Usually a pharmacist will remember that 1 tablet of 325mg Aspirin equals 5 grains. Just remember which ever one is easiest. Look at an aspirin box (OTC) next time they work. It has both mg and grains listed on the box. Maybe this will help you to remember. 18 Metric Conversions kl L mg Conversion is made simple by placing your kg g mcg decimal point at the end of the number and then makes loops to where you need to go. Place your decimal point here and fill in the loops with zeros. Moving right: The number gets larger If you go from one slash mark to one slash mark it is one loop. 1 L = 1. 0 0 0 Place decimal at the end of m1000 mloops= If you go from g to mg, it is three loops to the right so the original number is larger. 1 g = 1000 mg 1 mg = 1000 mcg If you go from mcg to g, it is 6 loops to the left so the original number is smaller. Moving left: The number gets smaller kg g mg mcg 1 g = 0 0 1. = 0.001 kg 1 mg = 0.001 g Let’s start easy:Moving the decimal to the right 1) 3 L = ______________ ml 2) 5.5 L = _______________ ml 3 g = ______________ mg 5.5 g = _______________ mg 3 mg = _____________ mcg 5.5 mg = ______________mcg 3 kg = ______________ g 5.5 kg = ______________ g Going the other way: 3) 6000 ml = ________________ L 6500 ml = ________________ L 8730 mg = ________________ g 8730 mg = ________________ kg 4385 mcg = _______________ mg 4385 mcg = _______________ g 19 If you think that was easy, try these: 52 ml = __________________ L 15 kg = ____________________ g 2.06 g = __________________ mg 2,785,000 mcg = _____________ kg 16 mcg = __________________ mg 2 kg = _____________________ mcg 256 mg = __________________ g 21 L = _____________________ ml 2,703,000 mcg = ____________ g 576 ml = ____________________ L 6.8 L = ____________________ ml 823 kg = ____________________ mg 62.5 mg = __________________ g 27 mcg = ___________________ mg a) A total regimen of therapy calls for 10 mg of a medication to be given to a patient over several days. In the pharmacy a solution is available that has 40 mcg/ml. How many ml must be dispensed b) A dose of medication that is 0.63 ml is given. The pharmacy stock solution contains 80 mg/15 ml. How many micrograms are in the dose c) A drug has a concentration of 25 mg/ ml. How many grams of the drug are in 1 liter d) A capsule of medication contains 35 mg of active ingredient. How many capsules would you need to accumulate 1.05 kg of the active ingredient e) If there are 56 mg/ml, how many grams are in a liter f) There