Your FREE PTCB Flashcards 2026 – 250+ Cards

ACE inhibitor — treats hypertension and heart failure. Watch for dry cough and hyperkalemia; contraindicated in pregnancy.

Beta-blocker (cardioselective, beta-1) — hypertension, angina, heart failure, post-MI. Slows heart rate.

Dihydropyridine calcium channel blocker — hypertension and angina. Common side effect: peripheral (ankle) edema.

HMG-CoA reductase inhibitor (statin) — lowers LDL cholesterol. Take at any time of day; monitor for muscle pain (myopathy).

Biguanide — first-line for type 2 diabetes. Lowers hepatic glucose output; hold before contrast dye (lactic acidosis risk).

Proton pump inhibitor (PPI) — GERD, peptic ulcers. Take 30–60 minutes before the first meal.

Synthetic T4 thyroid hormone — treats hypothyroidism. Take on an empty stomach; narrow therapeutic index.

Short-acting beta-2 agonist (SABA) — rescue inhaler for acute bronchospasm/asthma. Fast onset.

Vitamin K (phytonadione). Warfarin is an anticoagulant monitored by INR (target usually 2–3).

Protamine sulfate. Heparin is monitored by aPTT.

Naloxone (Narcan) — an opioid antagonist that reverses respiratory depression.

N-acetylcysteine (NAC, Acetadote/Mucomyst).

Flumazenil.

Lispro, aspart, glulisine — onset ~15 minutes. Give right before a meal.

Glargine (Lantus) and detemir (Levemir) — no pronounced peak, ~24-hour duration.

Loop diuretic — edema and hypertension. Can cause hypokalemia (low potassium).

Potassium-sparing diuretic / aldosterone antagonist. Risk of hyperkalemia.

Thiazide diuretic — first-line for hypertension. Can cause hypokalemia and raise glucose/uric acid.

Angiotensin II receptor blocker (ARB) — hypertension. Alternative when ACE inhibitors cause cough.

Antiplatelet (P2Y12 inhibitor) — prevents clots after stents and in ACS.

Direct oral anticoagulant (factor Xa inhibitor) — atrial fibrillation, DVT/PE. No routine INR monitoring.

Penicillin (beta-lactam) antibiotic. Augmentin = amoxicillin + clavulanate.

Macrolide antibiotic. Common 5-day Z-Pak regimen for respiratory infections.

Fluoroquinolone antibiotic. Boxed warning: tendon rupture; avoid with antacids/dairy (chelation).

Tetracycline antibiotic. Avoid in pregnancy and young children (tooth staining); photosensitivity.

Bactrim — a sulfonamide combination antibiotic for UTIs and MRSA. Sulfa allergy caution.

Anticonvulsant also used for neuropathic pain. Now a controlled substance in some states.

SSRI antidepressant. Used for depression and anxiety; takes weeks for full effect.

SSRI antidepressant with a long half-life.

SNRI — depression, anxiety, and neuropathic pain.

Benzodiazepine, Schedule IV controlled substance — anxiety. Risk of dependence.

Non-benzodiazepine 'Z-drug' hypnotic for insomnia. Schedule IV.

Norco/Vicodin — Schedule II opioid combination.

Schedule II opioid analgesic (OxyContin = extended release).

Oral corticosteroid — anti-inflammatory/immunosuppressant. Taper to stop; take with food.

Leukotriene receptor antagonist — asthma maintenance and allergic rhinitis.

Alpha-1 blocker — benign prostatic hyperplasia (BPH). Can cause orthostatic hypotension.

Phosphodiesterase-5 (PDE5) inhibitor — erectile dysfunction. Never combine with nitrates.

Xanthine oxidase inhibitor — lowers uric acid to prevent gout (not for an acute attack).

Cardiac glycoside — heart failure and atrial fibrillation. Narrow therapeutic index; toxicity worsened by low potassium.

Antiepileptic — seizures. Narrow therapeutic index; monitor levels.

HLA-B*1502 testing before use in at-risk patients (severe skin reactions/SJS).

Mood stabilizer for bipolar disorder. Narrow therapeutic index; monitor levels, sodium, and hydration.

Antibiotic/antiprotozoal — avoid alcohol (disulfiram-like reaction).

Centrally acting opioid analgesic, Schedule IV. Seizure and serotonin syndrome risk.

Schedule V — neuropathic pain, fibromyalgia, seizures.

DMARD/antimetabolite — rheumatoid arthritis and cancer. Often dosed WEEKLY (a daily error is fatal); give folic acid.

Parkinson disease — replaces dopamine; carbidopa prevents peripheral breakdown.

Treats anaphylaxis — give intramuscularly in the outer thigh.

5-HT3 antagonist antiemetic — prevents nausea/vomiting.

First-generation (sedating) antihistamine.

Second-generation (non-/less-sedating) antihistamines for allergies.

Proton pump inhibitor (PPI) — GERD; available IV in hospitals.

An H2 blocker (Zantac) withdrawn from the U.S. market over NDMA impurity; famotidine is the H2-blocker alternative.

Many — including antibiotics, NSAIDs, and vitamin-K-rich foods. Monitored by INR.

Unopened: refrigerate. Opened/in-use: usually room temperature for ~28 days (check the product). Never freeze.

Sublingual tablet for angina — store in original amber glass, away from light/heat; may repeat every 5 minutes ×3.

Generic names ending in '-olol' (metoprolol, atenolol, propranolol).

Generic names ending in '-pril' (lisinopril, enalapril, ramipril).

Generic names ending in '-sartan' (losartan, valsartan, olmesartan).

Generic names ending in '-statin' (atorvastatin, simvastatin, rosuvastatin).

Generic names ending in '-prazole' (omeprazole, pantoprazole, esomeprazole).

'-triptan' (sumatriptan) — abortive treatment of migraine.

Often end in '-pam' or '-lam' (lorazepam, diazepam, alprazolam).

Antibiotics ending in '-micin/-mycin' such as gentamicin; monitor for nephro-/ototoxicity.

'-dipine' (amlodipine, nifedipine).

Generic atorvastatin (a statin).

Generic levothyroxine.

Generic metformin.

Generic warfarin.

Generic omeprazole.

Generic amlodipine.

Generic lisinopril.

Generic albuterol.

Generic furosemide.

Generic gabapentin.

Generic metoprolol (tartrate / succinate XL).

Generic losartan.

Generic rosuvastatin.

Generic apixaban.

Generic rivaroxaban (factor Xa inhibitor).

Generic sitagliptin (a DPP-4 inhibitor).

Generic semaglutide (a GLP-1 receptor agonist).

Generic adalimumab (a TNF-inhibitor biologic).

'-gliptin' (sitagliptin, saxagliptin) — type 2 diabetes.

'-glutide/-tide' (semaglutide, liraglutide, dulaglutide) — type 2 diabetes and weight loss.

'-gliflozin' (empagliflozin, dapagliflozin) — diabetes and heart/kidney benefit.

'-mab' (adalimumab, infliximab) — biologic agents.

30–60 minutes before the first meal of the day.

Take on an empty stomach with a full glass of water; stay upright 30 minutes (esophageal irritation).

Avoid taking with dairy, antacids, or iron — these cations chelate the drug and reduce absorption.

Irregularly irregular rhythm — relevant because warfarin/DOACs and rate-control drugs are prescribed for it.

INR (international normalized ratio); therapeutic range usually 2–3.

Hypothyroid → levothyroxine (replace). Hyperthyroid → methimazole/PTU (suppress).

81 mg daily as an antiplatelet to reduce heart-attack/stroke risk in selected patients.

Ibuprofen, naproxen — anti-inflammatory; GI bleeding and kidney risk, especially with anticoagulants.

Generally no more than 4 g (4000 mg) per day in healthy adults; less with liver disease/alcohol use.

Vancomycin and aminoglycosides (gentamicin) — monitor trough levels for efficacy and toxicity.

Dosing insulin based on measured blood glucose — a high-alert process; double-check the units.

Anticoagulants (warfarin, heparin, DOACs) target clotting factors; antiplatelets (aspirin, clopidogrel) stop platelets clumping.

Tetracycline antibiotics (doxycycline, minocycline).

Fluoroquinolone antibiotics (ciprofloxacin, levofloxacin).

Penicillin antibiotics (amoxicillin, ampicillin).

Azole antifungals (fluconazole, ketoconazole).

Antiviral agents (acyclovir, oseltamivir, tenofovir).

NSAIDs, colchicine, or corticosteroids — NOT allopurinol (which is for long-term prevention).

Small dose changes matter; keep patients on the same manufacturer/product when possible.

Constipation (does not improve with time), sedation, respiratory depression, nausea.

Short-acting statins (simvastatin) work best in the evening; long-acting (atorvastatin, rosuvastatin) any time.

To reduce methotrexate's side effects (mucositis, GI upset); methotrexate is a folate antagonist.

Avoid tyramine-rich foods (aged cheese, cured meats) — hypertensive crisis risk.

Excess serotonin (e.g. SSRI + tramadol/triptan) — agitation, fever, tremor, rapid heart rate.

Room temperature, protected from light; do not refrigerate. Inspect that the solution is clear.

The fraction of a dose that reaches systemic circulation; IV = 100%; oral is reduced by first-pass metabolism.

Oral drugs are metabolized by the liver before reaching circulation, lowering the amount that takes effect.

The time for the drug concentration to fall by half; ~4–5 half-lives to reach steady state or clear the drug.

A condition under which a drug should NOT be used (e.g. ACE inhibitors in pregnancy).

The FDA-approved condition a drug is used to treat.

An unwanted, harmful response to a drug at normal doses; report serious ones via MedWatch.

Use of a medication to PREVENT a condition (e.g. propranolol for migraine prophylaxis).

Two drugs together produce a greater effect than the sum of each alone.

A loading dose rapidly reaches therapeutic level; a maintenance dose keeps it there.

Gradually adjusting a dose up or down to reach the best effect with the fewest side effects.

The ratio between a drug's effective and toxic dose; a NARROW index (warfarin, digoxin, lithium) needs monitoring.

What the body does to a drug: Absorption, Distribution, Metabolism, Excretion.

What the drug does to the body — its mechanism and effect at the site of action.

An agonist activates a receptor (produces a response); an antagonist blocks it (e.g. naloxone blocks opioid receptors).

Five schedules (I–V) by abuse potential. Schedule I has no accepted medical use; II–V do, with decreasing abuse potential.

No accepted U.S. medical use, high abuse: heroin, LSD, ecstasy, (federally) marijuana.

High abuse, accepted use: oxycodone, fentanyl, morphine, Adderall. NO refills allowed.

May be refilled up to 5 times within 6 months of the original date.

III: ketamine, anabolic steroids, Tylenol #3. IV: alprazolam, lorazepam, tramadol. V: low-dose codeine cough syrups, pregabalin.

Used to order/transfer SCHEDULE II controlled substances (or the electronic CSOS equivalent).

Used to record the DESTRUCTION of controlled substances.

Used to report the THEFT or significant LOSS of controlled substances.

Application for a pharmacy to register (and dispense) controlled substances.

Add 1st+3rd+5th digits, then (2nd+4th+6th)×2; the last digit of that sum must equal the 7th (check) digit.

Identifies registrant type (e.g. A/B/F = hospital/pharmacy/practitioner; M = mid-level); the 2nd letter = first letter of the last name.

A complete inventory at least every 2 years; an initial inventory when first handling controlled substances.

Must be kept SEPARATE from other records; many states require perpetual inventory for CII.

Combat Methamphetamine Epidemic Act: max 3.6 g/day and 9 g/30 days per purchaser; kept behind the counter with a logbook and ID.

Poison Prevention Packaging Act — requires child-resistant packaging for most oral prescription drugs (patient may waive).

Federal Food, Drug, and Cosmetic Act — required drugs to be proven SAFE before marketing; created the FDA's authority.

Required drugs to be proven EFFECTIVE (not just safe) — prompted by the thalidomide tragedy.

Created the legend (Rx-only) vs OTC distinction and the 'Rx only' label.

Health Insurance Portability and Accountability Act — protects patients' protected health information (PHI).

Omnibus Budget Reconciliation Act of 1990 — requires DUR and an offer to counsel patients on new prescriptions.

Created the DEA scheduling system (I–V) for drugs with abuse potential.

Drug Supply Chain Security Act — tracks drugs through the supply chain to keep counterfeits out (drug pedigree/track-and-trace).

Requires an in-person (or qualifying telehealth) evaluation before prescribing controlled substances online.

Added anabolic steroids to Schedule III of the Controlled Substances Act.

Risk Evaluation and Mitigation Strategy — an FDA safety program for certain high-risk drugs (e.g. isotretinoin/iPLEDGE, clozapine).

The FDA program for voluntarily reporting adverse events and product problems.

Vaccine Adverse Event Reporting System (CDC/FDA) — reporting adverse events after vaccination.

Adulterated = the product is contaminated/impure or improperly made. Misbranded = the labeling is false or misleading.

The Drug Enforcement Administration (DEA) — part of the Department of Justice.

The Food and Drug Administration (FDA).

Allowed in a genuine emergency for the amount needed; a written/e-prescription must follow within 7 days.

Generally a one-time transfer of remaining refills (shared real-time databases may allow more); CII cannot be refilled or transferred.

Patient name/address, drug, strength, quantity, directions, date, prescriber name/address and DEA number, and signature.

The manufacturer (often at the FDA's request); the pharmacy quarantines affected stock and notifies patients as directed.

A DEA-registered company that processes the return/destruction of expired or unwanted controlled substances.

Theft or redirection of (usually controlled) medications for non-medical use; prevented by counts, audits, and ADC tracking.

A running, real-time count of certain drugs (often CII) updated with each transaction.

Maintain required temperatures throughout storage/transport; log fridge/freezer temps and report excursions.

Some Schedule V products may be sold without a prescription where state law allows, with ID and a logbook.

Permitted under federal rules; the remainder is generally supplied within 30 days of the written date.

Pharmacy records (including controlled-substance records) are generally kept at least 2 years (states may require longer).

Required for many written prescriptions (especially Medicaid) to deter forgery.

Prescription Drug Monitoring Program — a state database tracking controlled-substance dispensing to curb misuse.

A licensed distributor that supplies drugs to pharmacies; the DSCSA tracks products through them.

OTC = available without a prescription; legend (Rx-only) requires a prescription (Durham-Humphrey).

OTC products kept behind the counter requiring a sale interaction (e.g. pseudoephedrine).

A drug that carries a heightened risk of significant patient harm if used in error — e.g. insulin, heparin, opioids, chemotherapy.

Write out 'unit' — 'U' can be misread as 0, 4, or cc, causing overdose (especially insulin).

Never write 1.0 mg (can be read as 10). Do use a leading zero: 0.5 mg, never .5 mg.

Ambiguous (morphine vs magnesium sulfate). Write the full drug name.

Mixed-case lettering to distinguish look-alike names, e.g. predniSONE vs prednisoLONE, hydrOXYzine vs hydrALAZINE.

Right patient, right drug, right dose, right route, right time.

An error caught and corrected before it reaches the patient.

An unexpected occurrence involving death or serious physical/psychological injury, requiring immediate investigation.

A retrospective process that identifies the underlying cause(s) of an error to prevent recurrence.

Failure Mode and Effects Analysis — a PROACTIVE method that anticipates how a process could fail before harm occurs.

The FDA's strongest warning, on the label, alerting to serious or life-threatening risks.

Comparing a patient's current medication list against new orders at care transitions to avoid errors and omissions.

Two drugs from the same class (or with the same effect) prescribed together, raising overdose/side-effect risk.

Look-Alike/Sound-Alike medications (e.g. hydralazine/hydroxyzine) — a leading source of errors; use tall man lettering and barcodes.

Institute for Safe Medication Practices — a nonprofit that publishes high-alert and confused-name lists and error-prevention guidance.

Standard for sterile compounding (preventing contamination of injectables, IVs).

Standard for safe handling of HAZARDOUS drugs to protect workers and the environment.

Standard for NON-sterile compounding (oral, topical preparations).

Work at least 6 inches inside; never block (shadow) airflow between the HEPA filter and the sterile object.

Horizontal LAFW protects the PRODUCT (non-hazardous sterile). Vertical/BSC protects the WORKER (hazardous drugs).

Chemo-rated gloves (often double), gown, and respiratory/eye protection per USP <800>; compound in a containment device.

Never recap needles by hand; drop them point-first into a puncture-proof sharps container (OSHA).

Class I = reasonable probability of serious harm or death; Class II = temporary/reversible harm; Class III = unlikely to cause harm.

Verifying the right drug/dose at dispensing and bedside to prevent the wrong-drug error.

Stop and flag it for the pharmacist — the technician does not override clinical alerts.

A list of potentially inappropriate medications in older adults (e.g. avoiding certain sedatives/anticholinergics).

Only the pharmacist may counsel on a new prescription; the technician facilitates the offer (OBRA-90).

Counsel patients clinically, make therapeutic decisions, perform the final verification, or override clinical alerts.

Verify at least two identifiers (e.g. full name and date of birth) before dispensing — never the room number.

The single most effective measure to prevent the spread of infection in the pharmacy/healthcare setting.

Used to contain and clean a hazardous-drug spill per USP <800>; includes PPE, absorbent pads, and disposal bags.

Physically separate recalled/expired drugs from usable stock and label clearly to prevent dispensing.

Pharmacy and Therapeutics committee — decides the formulary and medication-use policy in a hospital/health plan.

An IV infusion pump with a dose-error-reduction software library to catch programming errors.

A second qualified person independently verifies a high-alert preparation (e.g. insulin, chemo, pediatric doses).

The pharmacist provides clinical counseling; technicians may direct customers and answer non-clinical questions.

Similar vials/boxes cause selection errors — separate storage, barcodes, and alerts reduce the risk.

Use a leading zero (0.5 mg). Never use a trailing zero (write 5 mg, not 5.0 mg) — prevents 10-fold errors.

By mouth (orally).

IV = intravenous; IM = intramuscular; SubQ/SC = subcutaneous.

SL = sublingual (under the tongue); PR = per rectum.

Once, twice, three times, four times daily. (QD/QOD are on the ISMP do-not-use list — write 'daily'.)

QH = every hour; Q4H = every 4 hours; PRN = as needed.

AC = before meals; PC = after meals; HS = at bedtime.

gtt = drop(s); ung = ointment; supp = suppository.

stat = immediately; NPO = nothing by mouth.

Take one tablet by mouth twice a day.

Instill two drops in both eyes four times a day. (OD = right eye, OS = left eye, OU = both eyes.)

National Drug Code — a 10- or 11-digit number identifying the labeler, product, and package size of a drug.

Drug Utilization Review — a check (often automated) for interactions, duplications, dose problems, and allergies during processing.

A supplemental warning/instruction label on a dispensed prescription (e.g. 'Take with food', 'May cause drowsiness').

Insurer approval required before a drug is covered; the pharmacy/prescriber submits clinical justification.

Take 2 per day → 30 ÷ 2 = 15 days' supply.

Use ~20 drops per mL; divide total drops by drops used per day. (Account for both eyes and doses per day.)

Total actuations (puffs) ÷ puffs used per day. (Albuterol HFA = 200 actuations.)

Total units in the vial/pen(s) ÷ units used per day. (A 10 mL U-100 vial = 1000 units.)

Preparing a customized medication by combining/altering ingredients for an individual patient when a commercial product won't work.

Reducing a substance to a fine powder by grinding, often with a mortar and pestle.

Mixing a small amount of potent drug with an equal amount of diluent, then doubling repeatedly — ensures uniform distribution.

Adding a small amount of liquid (levigating agent) to a powder to make a smooth paste and reduce particle size.

Adding a specified volume of diluent (often sterile water) to a powdered drug to make a solution/suspension just before dispensing.

The date after which a compounded or repackaged product should not be used — based on USP, not the manufacturer's expiration date.

Expiration = manufacturer's date on the original container. BUD = assigned to compounded/repackaged products (usually shorter).

Unit-dose = a single packaged dose (common in hospitals). Bulk/multi-dose = larger stock containers.

An approved list of medications (often with preferred/tiered choices) a health plan or facility will cover or stock.

Dispensing a different drug in the same class than prescribed — requires prescriber/protocol approval (unlike generic substitution).

Dispensing an AB-rated generic for the brand; allowed unless 'dispense as written' (DAW) is specified.

DAW 0 = substitution allowed (no restriction). DAW 1 = prescriber requires brand ('dispense as written').

The real-time electronic claim process where the insurer approves the prescription and returns the patient's copay.

Insurance routing numbers on the card: BIN (Bank Identification Number) and PCN (Processor Control Number) direct the claim.

The fixed amount a patient pays for a covered prescription; the plan pays the rest.

The plan won't pay because too much supply remains; the patient may wait or pay cash.

A claim or dispense error where the billed NDC doesn't match the product dispensed — correct before dispensing.

A federal drug-pricing program that lets eligible safety-net providers buy outpatient drugs at reduced prices.

An online edit flags an interaction/duplication/early refill; the technician routes it to the pharmacist to resolve.

That the prescription is complete and valid — patient info, drug, strength, quantity, directions, prescriber, and date.

Cost or dose flexibility — but only scored/film-coated immediate-release tablets; never split extended-release or enteric-coated.

V = 5, X = 10, L = 50, C = 100. (I = 1.)

Grain — an apothecary unit; 1 grain ≈ 65 mg (often rounded to 60 mg).

1 kg = 2.2 lb; 1 lb = 16 oz. Convert pounds to kg by dividing by 2.2.

1 teaspoon = 5 mL; 1 tablespoon = 15 mL.

1 fl oz = 30 mL; 1 pint = 480 mL; 1 gallon = 3840 mL.

1 inch = 2.54 cm. 1 mL = 1 cc.

% w/v = grams of drug per 100 mL; % w/w = grams per 100 g; % v/v = mL per 100 mL.

1 gram of drug in 1000 mL (or g) → 1 mg/mL. (Epinephrine 1:1000 = 1 mg/mL.)

Calculates how to mix two strengths (high and low) to make a desired in-between concentration.

mL/hr = total volume ÷ infusion time (hours). Drops/min = (volume × drop factor) ÷ time in minutes.

A calculation method that cancels units step by step to reach the desired unit — reduces dosing errors.

Used mainly for chemotherapy — dose per square meter (mg/m²); BSA from height and weight.

The ratio of a substance's weight to the weight of an equal volume of water; water = 1. Used to convert weight and volume.

About 2–8 °C (36–46 °F).

About 20–25 °C (68–77 °F).

About −25 to −10 °C (−13 to 14 °F).

Moving a drug from a bulk container into unit-dose or smaller packages — assign a BUD and label fully.

Periodic Automatic Replenishment level — the minimum stock that triggers reordering for inventory control.

First Expired, First Out — stock the shortest-dated product to be used first to minimize waste.

A computerized cabinet (e.g. Pyxis/Omnicell) that stores and tracks medications on nursing units.

Medication Administration Record — documents each dose given to an inpatient.

Electronic transmission of a prescription from prescriber to pharmacy; EPCS covers controlled substances.

A standardized reference summarizing a drug's uses, dosing, interactions, and warnings.

A suspension has undissolved particles (shake well); a solution is fully dissolved (clear).

Protects the drug from stomach acid (or the stomach from the drug); do not crush — it bypasses the stomach.

Do not crush or split — it releases the full dose at once (overdose risk).

Buccal = dissolved between cheek and gum; sublingual = under the tongue. Both bypass first-pass metabolism.

Delivers drug through the skin over time (e.g. fentanyl, nicotine); rotate sites and remove the old patch.

Compounding is patient-specific; manufacturing makes large commercial batches (FDA-regulated differently).

503A = traditional patient-specific compounding pharmacy; 503B = an FDA-registered outsourcing facility making larger batches.