22 Medications & Pharmacology Practice Questions & Answers

1. 1. A refill request comes in for Synthroid. Which generic ingredient should the technician pull from the shelf?

   • A.Methimazole tablets
   • B.Levothyroxine sodium✓ Answer
   • C.Liothyronine sodium
   • D.Propylthiouracil tablets

   Synthroid is the brand name for levothyroxine sodium, a synthetic T4 thyroid hormone given to replace hormone in hypothyroidism. Liothyronine is synthetic T3, while methimazole and propylthiouracil do the opposite job — they suppress an overactive thyroid.

   Source: FDA-approved labeling, Synthroid (levothyroxine sodium); PTCE Content OutlineReport a problem with this question

2. 2. A patient asks which brand-name product corresponds to the metformin tablets on her profile. Which answer is correct?

   • A.Glucotrol, the glipizide brand product
   • B.Januvia, the sitagliptin brand product
   • C.Amaryl, the glimepiride brand tablet product
   • D.Glucophage, the metformin brand product✓ Answer

   Glucophage is the brand name for metformin, a biguanide that lowers hepatic glucose production in type 2 diabetes. Glucotrol (glipizide) and Amaryl (glimepiride) are sulfonylureas that stimulate insulin release, and Januvia (sitagliptin) is a DPP-4 inhibitor — different classes entirely.

   Source: FDA-approved labeling, Glucophage (metformin hydrochloride); PTCE Content OutlineReport a problem with this question

3. 3. A pharmacy stocks omeprazole, pantoprazole, and esomeprazole. The shared '-prazole' stem tells the technician these agents belong to which class?

   • A.Proton pump inhibitors, which block gastric acid secretion✓ Answer
   • B.Antacids, which chemically neutralize acid already present
   • C.Prokinetic agents, which speed gastric emptying and transit
   • D.Histamine-2 blockers, which act on parietal cell receptors

   The '-prazole' stem is reserved for proton pump inhibitors, which irreversibly inhibit the H+/K+-ATPase pump on the gastric parietal cell and so shut down acid production at its source. H2 blockers carry the '-tidine' stem instead, and antacids neutralize acid that has already been secreted rather than preventing its release.

   Source: FDA proton pump inhibitor class labeling; PTCE Content OutlineReport a problem with this question

4. 4. Metoprolol, atenolol, and carvedilol all carry the '-olol' stem. Which statement about this class is accurate?

   • A.They are beta-blockers and may worsen bronchospasm in asthma patients✓ Answer
   • B.They are alpha-1 blockers and are used mainly for prostate symptoms
   • C.They are calcium channel blockers and commonly cause ankle edema
   • D.They are ARBs and are chosen when a cough develops on another agent

   The '-olol' stem marks beta-adrenergic blocking agents. Because beta-2 receptors in the airways also mediate bronchodilation, non-selective and high-dose beta-blockers can provoke bronchoconstriction, which is why an asthma history on the profile is a recognized drug–disease concern to flag for the pharmacist.

   Source: FDA beta-blocker class labeling (metoprolol, atenolol, carvedilol); PTCE Content OutlineReport a problem with this question

5. 5. A patient profile lists losartan (Cozaar). The '-sartan' stem places this drug in which class, and what does it treat?

   • A.Angiotensin-converting enzyme inhibitor used for hyperlipidemia
   • B.Dihydropyridine calcium channel blocker used to prevent migraine
   • C.Loop diuretic used to relieve edema in heart failure patients
   • D.Angiotensin II receptor blocker used to treat hypertension✓ Answer

   Drugs ending in '-sartan' are angiotensin II receptor blockers; they occupy the AT1 receptor so angiotensin II cannot cause vasoconstriction, lowering blood pressure. ACE inhibitors ('-pril') act one step earlier in the same pathway and treat the same condition, which is why the two are a classic therapeutic-duplication pair rather than a lipid or migraine therapy.

   Source: FDA-approved labeling, Cozaar (losartan potassium); PTCE Content OutlineReport a problem with this question

6. 6. Lorazepam, diazepam, and clonazepam share the '-azepam' stem. Which class do they belong to?

   • A.Antipsychotics, agents that block central dopamine receptors
   • B.Barbiturates, older sedatives identified by the '-barbital' ending
   • C.Benzodiazepines, sedative agents that enhance GABA activity✓ Answer
   • D.Muscle relaxants, agents that act at the neuromuscular junction

   The '-azepam' and '-azolam' stems identify benzodiazepines, which bind an allosteric site on the GABA-A receptor and increase chloride conductance, producing sedation, anxiolysis, and muscle relaxation. Barbiturates are a separate older class recognized by the '-barbital' ending.

   Source: FDA benzodiazepine class labeling (boxed warning, 2020); PTCE Content OutlineReport a problem with this question

7. 7. A patient having an acute gout flare asks whether the allopurinol on his profile will stop the attack. What is allopurinol's role?

   • A.It dissolves existing joint crystals within hours of a dose
   • B.It relieves an acute flare by blocking prostaglandin production
   • C.It works as a rescue analgesic taken only when a joint hurts
   • D.It lowers uric acid production to prevent future flares✓ Answer

   Allopurinol is a xanthine oxidase inhibitor taken daily to reduce uric acid formation, so it is prophylactic maintenance therapy for chronic gout. It has no analgesic or anti-inflammatory action and can even precipitate a flare when first started, so acute attacks are managed with other agents chosen by the prescriber.

   Source: FDA-approved labeling, allopurinol (Zyloprim) — not effective in acute gouty attacks; PTCE Content OutlineReport a problem with this question

8. 8. A patient with asthma has both an albuterol HFA inhaler and a fluticasone/salmeterol inhaler. Which product is used first when sudden wheezing starts?

   • A.The fluticasone/salmeterol inhaler, taken as two extra maintenance puffs
   • B.The albuterol inhaler, because a short-acting beta-2 agonist works quickly✓ Answer
   • C.Either inhaler, since both relieve bronchospasm within a few minutes
   • D.The fluticasone/salmeterol inhaler, because it opens airways fastest

   Albuterol is a short-acting beta-2 agonist and is the rescue inhaler: it relaxes bronchial smooth muscle within minutes. Fluticasone/salmeterol is a controller combining an inhaled corticosteroid with a long-acting beta-2 agonist, and its labeling states it is not for relieving acute symptoms, so substituting it in an attack delays effective treatment.

   Source: FDA-approved labeling, albuterol HFA and Advair (fluticasone/salmeterol) — not for acute symptoms; PTCE Content OutlineReport a problem with this question

9. 9. Two weeks after starting lisinopril, a patient reports a persistent dry, tickling cough with no fever. This cough is most consistent with which explanation?

   • A.A known class effect of ACE inhibitors related to bradykinin✓ Answer
   • B.A common side effect of statins caused by muscle inflammation
   • C.An expected effect of beta-blockers due to airway constriction
   • D.A typical reaction to diuretics caused by fluid in the lungs

   ACE inhibitors block the enzyme that degrades bradykinin, so bradykinin accumulates in the airway and provokes a dry, non-productive cough in a minority of patients, usually within weeks of starting. It is a class effect, not an infection, and the technician documents the complaint and refers the patient to the pharmacist.

   Source: FDA ACE inhibitor class labeling (lisinopril) — persistent nonproductive cough; PTCE Content OutlineReport a problem with this question

10. 10. A patient taking atorvastatin reports new, unexplained aching and weakness in both thighs. Which adverse effect does this most suggest?

    • A.Hypokalemia from a loop diuretic, which causes cramping and weakness
    • B.Tendon inflammation, a labeled warning for fluoroquinolone antibiotics
    • C.Statin-associated myopathy, which can progress to rhabdomyolysis✓ Answer
    • D.Peripheral neuropathy, a known effect of long-term metformin use

    Statin labeling warns of myopathy presenting as unexplained muscle pain, tenderness, or weakness, which can advance to rhabdomyolysis with myoglobin release and kidney injury. Because that progression is potentially serious, the report is documented and sent to the pharmacist rather than dismissed as ordinary soreness.

    Source: FDA statin class labeling — myopathy and rhabdomyolysis warning; PTCE Content OutlineReport a problem with this question

11. 11. A patient is picking up a fluticasone inhaler used twice daily for asthma control. Which counseling point belongs on the label?

    • A.Rinse the mouth with water after each dose✓ Answer
    • B.Take the dose with a full glass of water and remain upright
    • C.Hold the breath for a full minute after each inhaled dose
    • D.Shake well and use only when sudden shortness of breath occurs

    Inhaled corticosteroid deposited in the mouth and throat suppresses local immunity and allows Candida to overgrow, producing oropharyngeal thrush and hoarseness. Rinsing and spitting after each dose removes that residue, and a valved spacer further reduces oropharyngeal deposition.

    Source: FDA-approved labeling, fluticasone propionate inhalation (rinse mouth after use); PTCE Content OutlineReport a problem with this question

12. 12. A patient stabilized on warfarin says she is starting a diet with large daily servings of kale and spinach. What is the concern?

    • A.Vitamin K in those greens opposes warfarin, so intake should stay consistent✓ Answer
    • B.Fiber in those greens binds warfarin, so doses must be taken at night
    • C.Vitamin C in those greens raises warfarin levels and the bleeding risk
    • D.Iron in those greens chelates warfarin and blocks its absorption fully

    Warfarin works by interfering with vitamin K–dependent clotting factor synthesis, so a sudden increase in dietary vitamin K from leafy greens counteracts the drug and lowers the INR. Patients are not told to avoid greens entirely; they are told to keep intake steady from week to week so the dose stays matched to the diet.

    Source: FDA-approved labeling, warfarin sodium (Coumadin) — vitamin K intake consistency; PTCE Content OutlineReport a problem with this question

13. 13. A doxycycline prescription is filled for a patient who also takes calcium carbonate antacids and a ferrous sulfate tablet. Which counseling point applies?

    • A.Take all three products together so the stomach is protected from irritation
    • B.Stop the antacid and the iron until the antibiotic course is finished
    • C.Take the doxycycline with milk to prevent nausea from the antibiotic
    • D.Separate the doxycycline from the calcium and iron by several hours✓ Answer

    Tetracyclines and fluoroquinolones form insoluble chelates with di- and trivalent cations such as calcium, iron, magnesium, and aluminum, which sharply reduces antibiotic absorption and can cause treatment failure. Spacing the doses by several hours preserves absorption without forcing the patient to abandon either therapy.

    Source: FDA-approved labeling, doxycycline — absorption impaired by antacids and iron; PTCE Content OutlineReport a problem with this question

14. 14. A patient who uses sublingual nitroglycerin for angina has a new sildenafil prescription on his profile. Why is this pairing flagged?

    • A.The combination triggers a rapid rise in blood pressure and headache
    • B.The combination reduces how much nitroglycerin is absorbed under the tongue
    • C.The combination increases the risk of bleeding from the stomach lining
    • D.The combination can cause a life-threatening drop in blood pressure✓ Answer

    Nitrates and PDE-5 inhibitors both raise cyclic GMP in vascular smooth muscle, and together they produce additive vasodilation that can cause profound, refractory hypotension. Sildenafil labeling therefore lists organic nitrates in any form as a contraindication, so the profile must go to the pharmacist before dispensing.

    Source: FDA-approved labeling, Viagra (sildenafil) — contraindicated with organic nitrates; PTCE Content OutlineReport a problem with this question

15. 15. A profile shows prescription naproxen taken twice daily, and the patient is buying a bottle of ibuprofen 200 mg for a headache. What issue does this raise?

    • A.No issue arises, because one is a prescription and one is over the counter
    • B.A therapeutic duplication arises, since both are NSAIDs and raise bleed risk✓ Answer
    • C.No issue arises, because the two agents act on different pain pathways
    • D.An interaction arises, because ibuprofen makes naproxen far less effective

    Ibuprofen and naproxen are both non-selective NSAIDs, so taking them together is same-class therapeutic duplication that multiplies cyclooxygenase inhibition without adding analgesia. NSAID labeling carries a boxed warning for gastrointestinal bleeding and ulceration, so the technician flags the overlap for the pharmacist before the sale.

    Source: FDA NSAID class labeling — boxed warning for GI bleeding; PTCE Content OutlineReport a problem with this question

16. 16. A patient's allergy field records anaphylaxis to amoxicillin, and a new cefuroxime prescription is entered. What should the technician do?

    • A.Cancel the prescription and tell the patient to call the prescriber back
    • B.Flag the profile for the pharmacist, as cephalosporins may cross-react✓ Answer
    • C.Process the prescription, since cephalosporins never cross-react at all
    • D.Change the drug to azithromycin, which is the standard substitute here

    Cephalosporins share a beta-lactam ring with penicillins, and their labeling directs caution because cross-sensitivity reactions occur, particularly where the side chains are similar. Judging whether a documented anaphylaxis permits a cephalosporin is a clinical decision, so the technician documents the allergy and routes the order to the pharmacist rather than changing or cancelling the drug.

    Source: FDA cephalosporin class labeling — penicillin cross-sensitivity precaution; PTCE Content OutlineReport a problem with this question

17. 17. A caregiver asks whether metoprolol succinate ER tablets may be crushed into applesauce for easier swallowing. What is the correct response?

    • A.Crushing is unsafe: it breaks the release mechanism and dumps the dose✓ Answer
    • B.Crushing is allowed only for the evening dose of a twice-daily regimen
    • C.Crushing is fine if the whole dose is swallowed within a few minutes
    • D.Crushing is fine, because the coating only masks an unpleasant taste

    Modified-release designations such as ER, XR, XL, SR, CR, DR, and LA, as well as enteric coatings, depend on an intact matrix or film to meter the drug out over hours or to protect it from stomach acid. Crushing or chewing defeats that control and releases a full day's dose at once, risking toxicity, so the pharmacist must be asked for a suitable alternative dosage form.

    Source: FDA-approved labeling, Toprol-XL (metoprolol succinate extended-release); PTCE Content OutlineReport a problem with this question

18. 18. A prescription reads 'ciprofloxacin otic suspension, 4 gtt in the left ear twice daily.' The patient asks about using the same bottle in the eye. Which statement is correct?

    • A.An otic drop may be placed in the eye when the drug name matches
    • B.An otic drop never goes in the eye, though an eye drop may go in the ear✓ Answer
    • C.An otic drop and an eye drop are interchangeable at the same strength
    • D.An otic drop may be placed in the eye after dilution with sterile saline

    Ophthalmic products must be manufactured sterile and buffered to tolerate ocular tissue, so they meet a higher standard than otic products and can be used in the ear when a prescriber directs it. Otic preparations are not required to meet that ophthalmic standard, and placing one in the eye risks irritation and infection, which makes this a well-known route error to catch at data entry.

    Source: FDA labeling for ophthalmic versus otic preparations (sterility requirements); PTCE Content OutlineReport a problem with this question

19. 19. A shipment label instructs 'Store in a refrigerator.' Under the USP storage definitions, which temperature range does that specify?

    • A.20 to 25 °C (68 to 77 °F), described as controlled room temperature
    • B.−25 to −10 °C (−13 to 14 °F), the range USP defines as a freezer
    • C.8 to 15 °C (46 to 59 °F), the range that USP describes as cool
    • D.2 to 8 °C (36 to 46 °F), the range USP defines for a refrigerator✓ Answer

    USP General Chapter <659> defines a refrigerator as a cold place maintained thermostatically between 2 and 8 °C (36 to 46 °F). Storing a refrigerated product warmer risks loss of potency, while letting it freeze can denature proteins such as insulin or vaccine antigens, so the monitored refrigerator range protects stability in both directions.

    Source: USP General Chapter <659> Packaging and Storage Requirements (storage temperature definitions)Report a problem with this question

20. 20. A patient wants her sublingual nitroglycerin tablets moved into a weekly plastic pill organizer with cotton added. What should she be told?

    • A.Keep the tablets in the refrigerator inside a clear plastic vial
    • B.Keep the tablets in the original glass container without cotton✓ Answer
    • C.Keep the tablets in the organizer as long as it closes tightly
    • D.Keep the tablets in the organizer, but change the cotton every week

    Sublingual nitroglycerin is volatile and sensitive to light, moisture, and air, so its labeling requires the original amber glass container with the cap tightly closed and no cotton, paper, or other drug stored with it. Cotton absorbs the active drug and plastic organizers let it escape, both of which can leave a patient with tablets that no longer relieve angina.

    Source: FDA-approved labeling, Nitrostat (nitroglycerin sublingual tablets) — storage in original container; PTCE Content OutlineReport a problem with this question

21. 21. A technician reconstitutes an amoxicillin oral suspension whose package insert states the mixed product is stable for 14 days when refrigerated. What must be done at that point?

    • A.Keep the manufacturer's printed expiration date and store at room temperature
    • B.Label the bottle with a 14-day discard date and direct the patient to refrigerate it✓ Answer
    • C.Write a discard date of 28 days, the standard for all reconstituted antibiotics
    • D.Write a discard date one year ahead, matching the dry powder's dating

    Once water is added, the antibiotic begins to hydrolyze and the long expiration date printed for the dry powder no longer applies. The discard date comes from the manufacturer's package insert for the reconstituted product and is written on the bottle at the time of mixing, together with the storage condition the insert specifies — here refrigeration for the stated 14 days.

    Source: FDA-approved labeling, amoxicillin for oral suspension (storage after reconstitution); PTCE Content OutlineReport a problem with this question

22. 22. A shelf label is printed as 'hydrOXYzine' beside 'hydrALAZINE.' Why are parts of these names capitalized?

    • A.The capitals mark the drugs that require refrigeration on that shelf
    • B.The capitals flag drugs that must be dispensed in unit-dose packaging
    • C.The capitals highlight the letters that differ in a look-alike pair✓ Answer
    • D.The capitals identify products that are stocked behind the counter

    This is Tall Man lettering, an error-prevention technique that capitalizes the dissimilar portion of two look-alike or sound-alike names so the eye is forced to the part that differs. Hydroxyzine is an antihistamine and hydralazine is a vasodilator, so the visual break, together with separated shelf placement and barcode scanning, guards against a wrong-drug selection.

    Source: ISMP List of Confused Drug Names with Tall Man Letters; PTCE Content OutlineReport a problem with this question

Practice questions based on the PTCB exam content outline. Not affiliated with the PTCB, and not medical advice. About the PTCE →