Answer 10 exam style questions on dosage forms and storage for the PTCE (the PTCB exam), each with the correct answer and why every wrong option is wrong.
Start the 10 questions →A fentanyl patch is applied to the skin and replaced every 72 hours to control chronic pain throughout the body. Which term best describes this dosage form?
These questions cover dosage forms: transdermal patch, dosage forms: ophthalmic vs otic, dosage forms: release abbreviations, dosage forms: orally disintegrating tablets and dosage forms: inhaler types. Each one shows the correct answer and why every other option is wrong, so a miss tells you exactly what to review before the PTCE.
Prefer to read first? Every question from the practice set above, with the correct answer and why each wrong option is wrong.
Answer: D. A transdermal system delivers drug through the skin into the systemic circulation at a controlled rate, which is how a fentanyl patch provides around-the-clock pain control.
Why not A: Topical creams act mainly where they are applied. A fentanyl patch is designed for systemic absorption.
Why not B: A subcutaneous depot is injected under the skin. A patch is applied on the skin, not injected.
Why not C: A buccal film dissolves against the inside of the cheek, not on the skin.
Exam tactic: Patch for a whole-body effect = transdermal (through the skin).
Answer: A. Ophthalmic preparations must be sterile and formulated for the eye. Otic preparations are made for the ear canal and must never be used in the eye, so they cannot replace an ophthalmic product.
Why not B: In this case both products contain ofloxacin. The issue is the formulation and intended route, not the active ingredient.
Why not C: Otic antibiotic drops are not controlled substances. Scheduling has nothing to do with the problem.
Why not D: Ofloxacin otic is a prescription product. Availability status is not why it cannot be substituted.
Exam tactic: Eye products can never be replaced with ear products. Otic = ear only.
Answer: C. DR stands for delayed-release. The tablet or capsule releases drug after leaving the stomach, usually because of an enteric coating, as in pantoprazole DR.
Why not A: XL means extended-release: drug is released slowly over a long period, not delayed until after the stomach.
Why not B: SR means sustained-release, another extended-release term, not delayed-release.
Why not D: ODT means orally disintegrating tablet, which dissolves on the tongue.
Exam tactic: DR/EC = delayed (after the stomach). ER/XL/SR/CR = extended (slow over time).
Answer: C. An ODT disintegrates rapidly on the tongue and is swallowed with saliva, so no water is needed. Ondansetron is available as an ODT.
Why not A: Extended-release tablets must be swallowed whole and release drug slowly. They do not dissolve on the tongue.
Why not B: Enteric-coated tablets are swallowed whole and dissolve in the intestine.
Why not D: A film-coated tablet is swallowed whole. The thin coating eases swallowing or masks taste; it does not make the tablet dissolve on the tongue.
Exam tactic: ODT = melts on the tongue, no water.
Answer: A. The fluticasone/salmeterol Diskus is a dry powder inhaler. The patient's quick, deep inhalation pulls the powder into the lungs, and there is no propellant.
Why not B: Ventolin HFA is a metered-dose inhaler. HFA is the propellant that sprays each dose.
Why not C: Symbicort is a pressurized metered-dose inhaler with a propellant, not a dry powder.
Why not D: A nebulizer solution is turned into a mist by a machine. It is not a dry powder inhaler.
Exam tactic: HFA/aerosol = propellant MDI. Diskus, Ellipta, HandiHaler = dry powder.
Answer: D. A spacer attaches to a pressurized metered-dose inhaler. It holds the spray so the child does not have to coordinate pressing and breathing, and more drug reaches the lungs.
Why not A: Dry powder inhalers depend on the patient's own breath and are not used with a spacer.
Why not B: A nebulizer delivers mist through a mask or mouthpiece. It does not use a spacer.
Why not C: Nasal sprays deliver drug into the nose. Spacers are for oral inhalers.
Exam tactic: Spacer goes with MDI (HFA). Never with a dry powder inhaler.
Answer: A. USP controlled room temperature is 20°C to 25°C (68°F to 77°F). Brief excursions between 15°C and 30°C are tolerated, but the product should be kept within 20°C to 25°C.
Why not B: This is the allowed excursion range for brief periods, not the intended storage range.
Why not C: This is the refrigerator range. The label calls for room temperature storage.
Why not D: This is the USP cool range, which is below controlled room temperature.
Exam tactic: Room temp 20-25°C (68-77°F). 15-30°C is only the excursion allowance.
Answer: C. Varicella vaccine is stored frozen, between -50°C and -15°C (-58°F and +5°F). It may be kept in the refrigerator only for a limited time stated in its labeling.
Why not A: Inactivated influenza vaccine is refrigerated at 2°C to 8°C and is damaged by freezing.
Why not B: Tdap is refrigerated at 2°C to 8°C. Freezing inactivates it.
Why not D: Hepatitis B vaccine is refrigerated at 2°C to 8°C and must not be frozen.
Exam tactic: Most vaccines: fridge, never freeze. Varicella (Varivax): freezer.
Answer: B. Exposed vaccine is labeled Do Not Use, kept separated under proper storage conditions, and reported so the pharmacist or vaccine coordinator can contact the manufacturer or immunization program for a usability decision.
Why not A: Vaccine is not discarded before the manufacturer or immunization program determines whether it can still be used.
Why not C: Exposed vaccine must not be used until its viability is confirmed. Freezing can inactivate influenza vaccine.
Why not D: Inactivated influenza vaccine must never be frozen. This would cause further damage.
Exam tactic: Excursion: Do Not Use label, separate, store correctly, report. Do not discard yet.
Answer: D. Vaccines stay in original packaging to protect from light and keep lot information together, and are placed in the middle of the unit, away from walls, vents and the door, where temperature is most stable.
Why not A: The door has the greatest temperature swings each time it opens. Vaccines are never stored in the door.
Why not B: Removing vaccines from their boxes exposes them to light and separates them from lot and expiration information.
Why not C: Food and drink do not belong in a vaccine storage unit.
Exam tactic: Vaccines: original box, middle of the unit, never in the door.
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