Special Handling - Pharmacy Technician Certification Exam Ptce

1. What does the NIOSH "hazardous drug" (HD) designation indicate for pharmacy handling?

   A drug requiring special precautions to prevent worker exposure. NIOSH designates drugs as hazardous if they exhibit toxicity risks like carcinogenicity, requiring specialized handling to minimize occupational exposure.

2. Which storage instruction applies to a drug labeled "protect from light" during dispensing?

   Keep in light-resistant container or original packaging. Light exposure can degrade photosensitive drugs, so protective packaging prevents photochemical reactions and maintains potency.

3. Which USP chapter covers nonsterile compounding requirements that may apply to hazardous drugs?

   USP <795>. USP <795> outlines standards for nonsterile compounding, which include precautions for handling hazardous drugs to prevent contamination and exposure.

4. What is the correct action when you find a vial labeled "Do not freeze" stored in a freezer?

   Quarantine and notify pharmacist; do not dispense until stability is confirmed. Freezing can alter the drug's physical properties or stability, necessitating verification before use to ensure safety and efficacy.

5. Which engineering control is commonly used for sterile hazardous compounding of antineoplastics?

   Class II biological safety cabinet (BSC) or compounding aseptic containment isolator. These controls provide HEPA-filtered airflow and containment to protect both the product and personnel during sterile hazardous drug preparation.

6. Identify the correct handling for hazardous drugs that must not be crushed, opened, or manipulated.

   Dispense intact; avoid manipulation and use alternative dosage form if needed. Manipulating hazardous drugs releases particles or vapors, increasing exposure risks, so intact dispensing preserves containment.

7. Which storage instruction applies to a drug labeled "protect from moisture" during dispensing?

   Use tight container; keep desiccant if provided; avoid humid areas. Moisture can cause hydrolysis or clumping in sensitive drugs, so tight containers and desiccants preserve stability during storage.

8. Which auxiliary label is required for an oral medication that must be taken with food to reduce GI upset?

   Take with food. Food reduces gastrointestinal irritation for certain drugs by buffering the stomach lining and slowing absorption.

9. Which personal protective equipment is required when there is splash or aerosol risk with hazardous drugs?

   Gown plus eye/face protection (and appropriate respirator if needed). This PPE combination protects against potential splashes or aerosols, with respirators added for respiratory hazards as per risk assessment.

10. Which administration requirement applies to extended-release (ER/XR) tablets regarding crushing?

    Do not crush or chew; swallow whole. Crushing disrupts the controlled-release mechanism, potentially causing dose dumping or reduced efficacy.

11. Which auxiliary label best applies to a medication that must be stored at $2$–$8\,^{\circ}\mathrm{C}$?

    Refrigerate. Refrigeration maintains stability for drugs requiring $2$–$8\,^{\circ}\mathrm{C}$ storage to prevent degradation or loss of potency.

12. Which direction of airflow is required in a hazardous drug buffer room to contain contamination?

    Negative pressure relative to adjacent areas. Negative pressure ensures that airborne contaminants are contained within the room, preventing spread to adjacent cleaner areas.

13. Which USP chapter governs sterile compounding requirements that affect hazardous sterile preparations?

    USP <797>. USP <797> sets standards for sterile compounding, including specific requirements for preparing hazardous sterile preparations to ensure safety and sterility.

14. What is the minimum glove requirement when handling hazardous drugs (receiving, counting, compounding)?

    Chemotherapy-tested gloves. ASTM-tested chemotherapy gloves are required to provide a barrier against permeation by hazardous drugs during various handling activities.

15. Which auxiliary label is required for a medication that causes photosensitivity with sun exposure?

    Avoid sunlight. Photosensitive medications can cause skin reactions upon sun exposure, so the label promotes protective measures for patient safety.

16. Which USP chapter provides core standards for handling hazardous drugs in healthcare settings?

    USP <800>. USP <800> establishes guidelines for safe handling of hazardous drugs to protect personnel, patients, and the environment in healthcare settings.

17. What temperature range defines freezer storage for medications labeled "store frozen"?

    Approximately $-25$ to $-10\,^{\circ}\mathrm{C}$ (per product labeling). Freezer storage preserves medications sensitive to higher temperatures, with ranges specified to maintain integrity per manufacturer guidelines.

18. Which auxiliary label is required for an oral medication that must be taken on an empty stomach?

    Take on an empty stomach. An empty stomach enhances absorption for drugs affected by food, ensuring optimal bioavailability and therapeutic effect.

19. What temperature range defines controlled room temperature for most medications?

    $20$–$25\,^{\circ}\mathrm{C}$ (with permitted excursions). This range ensures medication stability at typical ambient conditions, allowing brief excursions without compromising efficacy.

20. What is the correct action if a hazardous drug tablet must be split but is not scored?

    Do not split; contact pharmacist for an alternative or safer formulation. Splitting unscored hazardous tablets can generate dust and increase exposure risk, so alternatives are preferred to maintain safety.

21. What is the correct action if a refrigerated medication arrives warm and outside labeled excursions?

    Quarantine and notify pharmacist; do not stock or dispense. Exceeding temperature excursions can compromise drug stability and safety, requiring quarantine to avoid patient harm.

22. What is the correct disposal category for trace hazardous drug waste (empty vials, used gloves) per policy?

    Trace hazardous waste container (often yellow), per facility procedure. Trace hazardous waste requires segregated disposal to comply with environmental regulations and prevent contamination.

23. What is the correct handling for a medication labeled "shake well" at dispensing?

    Apply "Shake well" auxiliary label and ensure patient receives the instruction. Shaking ensures uniform suspension of ingredients in liquids, promoting accurate dosing and consistent efficacy for the patient.

24. Which option is correct for transporting a refrigerated medication to maintain cold chain integrity?

    Use insulated packaging with cold packs and minimize time out of refrigeration. Insulated packaging with cold packs maintains the required temperature range during transit, preserving the medication's cold chain.

25. What is the primary purpose of a closed-system transfer device (CSTD) for hazardous drugs?

    To mechanically prevent HD escape and environmental contamination. CSTDs provide a sealed mechanism during drug transfer to contain hazardous substances and reduce the risk of leaks or aerosolization.

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