PHARMACY LAW
Federal Food and Drug Act (FFDA)
– Series of consumer protection laws
– led to creation of the FDA
– banned foreign and interstate traffic in adulterated or mislabeled food and drug products
– Products had to be inspected and offenders where prosecuted
– Active Ingredients had to be placed on labels of packaging
– drugs can not fall below purity levels set by United states pharmacopoeia or national formulary
Health Insurance Portability and Accountability Act (HIPAA)
– reduces health care fraud and abuse
– mandatory industry wide standards for health care information and electronic billing processes
– requires the protections and confidential handling of protected health information
Omnibus Budget Reconciliation Act
OBRA
– Allowed workers and families to keep their group coverage in cases of voluntary or involuntary job loss
– in case of reduced hours worked
– job transitions
– give workers who lost their health benefits right to choose to continue plans under certain circumstances
– required under businesses with 20+ employees
– applies to both government and private sector
– set period of time, maybe influenced by circumstances
OBRA 90
– placed regulations on how to interact with patients
– record keeping mandates, prospective drug reviews
– counseling obligations
– must review medicaid participants entire drug profile before prescribing medications
Medicaid
– Social Health care program for families and individuals with low income + resources
– government insurance for people of all ages who cannot afford sufficient health care
– varies from state to state –> joint funded between state and federal
– must be US citizens or legal permanent residents
Medicare
– National Social Insurance Program
– administered by US government
– provides insurance for Americans aged +65
– members must have worked and payed for the system
– provides insurance for younger people with disabilities
Disability
– Form of insurance that ensures the beneficiaries income against the risk that disability creates a barrier for a worker to complete the core functions of their work
– encompasses paid sick leave, short term disability benefits, and long term disability benefits
U.S. Social Security Act
– Social Welfare Legislation Act
– provides federal assistance to those who cannot work
–
Combat Methamphetamine Epidemic Act
– enacted to curb the growing problem of underground manufacture of illegal drugs
– regulates over the counter products that can be used to make illicit drugs
– include daily sales limits and 30 day purchase limits
– places products out of easy reach
– sale logbooks
– customer ID verification
– training of employees and sellers
Sale of Ephedrin
– sale is limited to behind the counter
– must present photo ID
– stores require to keep personal information on buyers for at least 2 years
– sales allowed in drive through lanes
U.S. Merck + co
– An American pharmaceutical company
– one of the largest in the world
– publishes Merck Manuals –> a series of reference books for medical professionals
– Merck Index –>list of chemical compounds –> lost
Poison prevention Packaging Act (PPPA)
– requires use of child resistant packaging for prescription drugs, OTC, household chemicals, and hazardous materials
– some drugs are exempt from child proof packaging –> OTC drugs with the proper labeling not for children and in big enough packages
Kefauver – Harris Act
– requires drug manufacturers to provide proof of their effectivness and safety before approval
– requires drug advertisements to disclose side effects
– stopped cheap generic drugs from being marketed as more expensive drugs and taking credit as breakthrough medications
Controlled Substances Act (CSA)
– federal US drug Policy
– manufacture, importation, possession, use and distribution of certain substances is regulated
– created 5 classifications of schedules
– all controlled substances need to be inventoried Biannually
Schedule I Drugs
– High Potential for abuse
– no potential medical use or treatment in US
– lack of accepted safety for use of drug under medical supervision
– No prescriptions may be written for drugs
– Crimes involving drugs can be quite serious
– “Street” Drugs
– Heroin, methamphetamine, cocaine, etc.
Schedule II Drugs
– Drugs have high potential for abuse
– Drugs have currently accepted medical uses, although there may be serious restrictions
– Abuse of drug may lead to severe psychological or physical dependence
– may not be used unless directly dispensed by a practitioner
– refills not allowed
– must be stored in a safe, while other schedules can be stored throughout pharmacy
Schedule III Drugs
– has potential for abuse, but to a lesser degree than schedules I + II
– drug has an accepted medical treatment
– abuse of drug may lead to moderate or low physical dependency or high psychological dependence
– may not be dispensed without a prescription
– may not be dispensed six months after prescription written
– may not be refilled more than 5 times
– may be prescribed orally or over phone
Schedule IV Drugs
– low potential for abuse
– has currently accepted medical use
– abuse may lead to limited physical or psychological dependence
– can be refilled up to five times after 6 months written or orally
Schedule V Drugs
– low potential for abuse
– currently accepted medical use
– limited dependence
– may be dispensed without medical reason
– orally or written
DEA form 222 1 + 2 order form
– Order Forms for Schedule 1 and 2 drugs
– used to order from another registrant retail and hospital pharmacies
– wholesaler or retailers use this form
– forms need to be maintained for 2 years
DEA Form 41 form of controlled substances
inventory and destruction
– registers inventory of controlled substances
– used to return drugs to DEA or acceptable recipients
– documents surrender or destruction of controlled substances
– forwarded to DEA for disposal
DEA 82 form of inspection
– Notice of Inspections of controlled premises
– informs registrant an inspection will be made
DEA form 104 surrender and close
– Voluntary surrender of controlled substance privileges
– used to surrender permit to the DEA on a voluntary basis
– used to close pharmacies
DEA 106/666 (loss or theft)
– report loss or theft of controlled substances
– Report discovered shortage of controlled substances
DEA 222a
– used to obtain DEA 222 form from DEA
DEA 224 license form – institutions
– new application for registration of controlled substances act
– Form used by retail pharmacies, clinics, hospitals, practitioners, and teaching institutions,
– to get license to obtain or dispense controlled substances
DEA 225 license form sellers
New application for registration used by manufacturers, distributors , wholesalers, importers, exporters, researchers
– to obtain and use controlled substances
DEA 226
application for re-registration of controlled substances
– privileged by retail pharmacies, hospitals, practitioners or teachers to obtain or dispense controlled meds
DEA 363 narcotics for pharmacy programs
– Registration for narcotic rx programs
– used to obtain approval narcotic rx program using controlled substances
Ordering and recipt of samples
Only a practicioner who has been issued individual DEA numbers are authroized to recieve any controlled substances in a sample, starter pack, or any container
– Only those with industrial prescribing authority are allowed to order / receive any dangerous drug sample/starter pack
Insulin Storage
– recommended temperature is 36 – 46 F
– unopened lasts until expiration date
– Vials and cartridges can be 59-86 F up to 28 days
– if altered only two weeks
– loses effectiveness when exposed to extreme temperatures or sunlight
Capsule sizes
– size 5 is the smallest (bigger numbers are smaller)
– su07 is the largest
– length and diameter increases as number
decreases
Capsule Information
– both types of capsules made from aqueous gelling agents –> mainly gelatin but sometimes cellulose
Hard Shelled Capsules
– made of gelatin
– contain dry powdered ingredients
– made in two halves –> lowered body is filled
– then sealed by higher diameter cap
Soft Shelled Capsules
– primarily used for oils and active ingredients that are dissolved or suspended in oil
– Single piece encapsulating method
– sealed with a single drop of gelatin
DEA numbers
– assigned to health care providers by the DEA allowing them to write prescriptions for controlled substances
– legally used solely to track controlled substances
– Also used by the Industry as general prescriber numbers –>unique identifier for anyone who can prescribe medications
DEA sections
– Contains 2 letters, 6 numbers, and 1 check digit
– First Letter is code identifying type of registrant
–> letters A – X depending on job type
– 2nd Letter is the first letter of the registrants last name
– Seventh number is the checksum
Seventh Number
– sum of digits 1, 3, 5
– then sum the digits of 2, 4, 6 and multiply by 2
– add the two sums together = CHECK
– Right most digit of the CHECK number is the 7th digit
Material Safety Data Sheet (MSDS)
– component of product stewardship, occupational safety and health, and spill handling procedures
– catalog information on chemicals, compounds, and mixtures
– info on safe use and potential hazards
– should be available for reference where chemicals are being stores
– for work settings
Drug-Drug interactions
– whenever two or more drugs are taken, there is a chance that there will be interactions
– may increase or decrease the effects of intended uses and side effects
– more drugs taken more likely interactions will occur
Ways drug drug interactions occur
– absorption rate into the body
– distribution of drug throughout the body
– alteration made to drug in body –> metabolism
– elimination of drug from the body
Contraindicated
– Never take these drugs together
– high risk for dangerous interaction
– contra bad
Serious
– Potential for serious interaction
– regular monitoring by doctor is required
– alternate medicine may be necessary
– monitoring by serious black
Significant
– Potential for significant interaction
– monitoring by doctor likely required
Minor
– Interaction is unlikely, minor, or insignificant
FDA Class I Recall
– Dangerous products that could cause serious health problems or death
– contain toxins, allergens, label mix ups, defects
FDA Class II Recall
– for products that might cause a temporary health problem
– pose slight threat of serious nature
FDA Class III Recall
– For products unlikely to cause any adverse health reactions
– still violate FDA labeling and manufacturing laws
– container defects, lack of proper labeling, wrong color/taste
FDA Class Recalls
– company can call a recall on their own after discovering flaw
– FDA can call a recall
– if recall is not done FDA can call a seizure of product
– must quickly remove products that are potentially dangerous from the market
– Firms must take full responsibility for removal of dangerous products
–
Drug Expiration Guidelines
– Final day the manufacturer guarantees the drug to perform at full potency and safety
– exist on medication labels –> required by law
– no recommendation about drug given after expiration
– drugs typically last 12 – 60 months
– after container is opened, expiration no longer reliable
– shelf life may actually be longer than expiration date
– If just the month and year are indicated –> drug can be used or dispensed until the last day of that month
Strenght of solutions
– need to be calculated in grams/ml
Business days
– do not include weekends
– day an order arrives does not count as a business day
– do not include federal holidays
AMA
– American Medical Association
– largest associations of physicians and medical students in US
– promote art and science of medicine to better public health
– advance interests of physicians and patients and lobby for favorable legistlation
– raise money for medical education
– Publishes JAMA, Largest circulation of any weekly medical journal
PFC
– Pharmacy Formulary commitee
– lists all mediciens
– annualy updates drugs and ingredients
– standards must be met for strength, quality, and purity
HPhA
– Hospital Pharmacist Association
– Professional organization that represents the interests of pharmacists who practice in hospitals, health maintanence, long term care facilities, home care
P&T
– Pharmacy and Therapeutics commitee
– comittee at a hospital or insurance plan that meets to decide what drugs will appear at that entities drug formulary
– consists of physicians and pharmacists
– weigh cost benifits of each drug and decide which to use
NDC
– National Drug Code
– unique product identifier for drugs intended for human use
– registered drug establishments must provide FDA with a current list of all drugs manufactured
– 10 digit, 3 segment numeric identifier assigned to each medication
– once an NDC is assigned to a product, it may not be reused
– sometimes referred to as the drug listing act of 1972 – for coding
NDC segment 1
– first segment is the labelor code
– 4 or 5 digits
– assigned by FDA upon submission of a labelers code request
– labeler is any form that manufactures, repacks, or distributes a drug product
Second segment
– Product Code
– 3 or 4 digits long
– identifies a specific strength, dosage form, and formulation for a particular firm
– assigned by the labeler
third segment
– Package code
– 1 or 2 digits long
– identifies package forms and sizes
– assigned by the labeler
Orange Book
– Approved drug products with therapeutics equivalence evaluations
– identifies drugs approved on basis of safety and effectiveness by FDA
– lists patents
Red Book
– Multi volume treatise outlined fiscal law
– pricing and product information for drugs
– answers commonly asked question
Therapeutic Equivalence Index
– for generic drugs
PDR
Physicians Desk Reference
– commercially published compilation of manufacturers prescribing information, package inserts on prescription drugs
– provides physicians with list of fully mandated information for writing prescriptions
– widely available in libraries and bookstores
Auxiliary labels
For the X
– easily identifiable stickers –> bright colors with easily identifiable graphics
– available in Spanish and french
– contains warnings, Instructions for route of admission, Dietary information
– short to the point phrases
PTCB Certification
– every 2 years a minimum of 20 hours of continued education is neceassary
– 1 hour must be on patient safety
Min/Max inventory size
– the min is the numerator –> once point is reached a new order is needed to be placed
– max is denominator –> what the new order would reach up to
PPPA exception
– nitroglycerin SL
– aspirin or acetaminophen — powder or tablets
isosorbid dinitrate
– erythromycin ethyl succinate
– potassium supplements
– sodium flouride
– betamethasone
– oral contraceptives
– pancrelipase
– anhydrous cholestyramine
– hormone replacement therapy
– sucrase
– estrogen tablets
Medicare Part A
– Hospital Insurance covers most medically necessary hospital care, skilled nursing facilities, home health and hospice care
– Free if you have worked and paid social security for more than 10 years (40 calender quarters)
– if less than montly premium will be paid
Medicare Part B
– Medical Insurance covers most medically necessary doctor, preventative care, medical equipment, hospital outpatient services, lab tests, mental health care, and home + ambulance
– always pay monthly premium
Medicare Part C
– Part of policy that allows private insurance companies to provide Medicare benifits
– not a seperate benifit
– include HMOs and PPOs
– known as Medicare Advantage plans
Medicare Part D
– outpatient prescription drug insurance
– provided only through private insurance companies that have contacts with the government
– never directly provided by the government
– must choose coverage that works with Medicare benefits
Durham – Humphrey Amendment
Defined two specific kinds of medications
– Legend drugs ( Prescriptions)
– Over the counter Drugs
– legend drugs include drugs with habit forming or harmful side effects
Tall Man lettering
Practice of writing part of a drugs name in upper case letters to help distinguish drugs that sound and look alike
– to avoid errors
– only for portion of drug name that are similar
PPI (prescription package inserts)
– leaflet for provided along with prescription and OTC drugs
first section contains information such as generic name,
second –> pharacology, indications, warnings, administration, dependence, overdose
– how medicine works in the body, absorned + eliminated, effects –> included in pharmacology section
Medicaid tamper resistant prescription act
– requires physicians to use electronic or tamper proof pads for their patients
Prescription Drug Marketing Act of 1987
USP <797> hand hygiene
– gives advice to practitioners for procedures and practices
– must wash hands and forearms to elbow for 30 seconds
– remove debris from under fingernails with nail cleaner and warm water
– do not use antimicrobial scrub brushes on the skin because they can cause skin shedding
– dry hands and forearms completely using lint free disposable wipes of electronic dryer
Class a balance
– has sensitivity of 6mg with no load –> 6 mg will move the counter of the balance 1 point
– 10 g on each pan
– required to be in pharmacy
– should be used for all weighing operations for prescription compounding
– do not weigh less than 120mg –> less is require mix with diluent –> to avoid unmeasured error
– do not weigh more than 120 g
iPLEDGE Program
mandatory distribution program for isotretinoin
– intended to prevent use of the drug during pregnancy
– required by law for patients and their doctors to use a website to in order to receive this medication
BIN number
– leading 6 digits on the bank card numbers
– can be used by pharmacies to process claims
SIGS and Directions
PRN- As needed
C- With UD As Directed
SS – Half
AA – Of Each
QS – Qty. Sufficient
DC – Discontinue
Pure Food and Drug Act *** 1906
1st law dealing with pharmacy
Prohibits interstate transportation or sale of aldulterated or misbranded drugs
The Harrison Narcotic Act of 1914
Created to regulate opium, coca leaves, etc
Deemed unlawful for importation and distribution of opiates & required a prescription for opioids
Food, Drug and Cosmetic Act (FDCA) 1938
Created FDA
Compelled manufacturers to demonstrate safety of new drugs- all new drug pplications must go through FDA
Allowed inspection by the FDA at manufacturers
Clearly defined adulteration and misbranding
and defined -drug/ device/ cosmetic /what is necessary to label product
Durham-Humphrey Amendments to FDCA 1951
Differentiated Legend “RX” and Non-legend “OTC”
Allowed phone in prescriptions by MD to Pharmacist
All Legend drugs must have “Caution: Federal Law prohibits dispensing without a Prescription”
Kefauver-Harris Amendment to FDCA 1962
Must have GMP (Good Manufacturing Practices)
Added more controls on clinical investigations
Requires all medications in US to be pure, safe and effective
Comprehensive Drug Abuse Prevention and Control Act 1970
Created DEA
Classified into 5 scheduled classes
C-I / C-II/ C-III / C-IV / C-V
Poison Prevention Packaging Act 1970
enacted to reduce poisoning
Required most OTC and Legend drugs to be packaged in Child proof containers
Exempt products: Inhalers/ Nitroglycerin (SL)/ cholestyramine
Occupational Safety and Health Act of 1970
Created OSHA
ensure a safe and healthful workplace for employees
Requires SDS to be at locations
Drug Listing Act 1972
Required -NDC-National Drug Code numbers to be assigned to every marketed drug
Federal Privacy Act of 1974
Regulates what personal information the Federal government can collect about private individuals
Medical Device Amendment Act of 1976
Classification of medical device according to function
Establish performance standards
Drug Price Competition and Patent Term Restoration Act 1984 AKA Hatch-Waxman Act
Encouraged the creation of both generic and new meds
Streamlined the generic approval process
Prescription Drug and Marketing Act 1987
Prevents re-importation of a drug into US
Prohibited hospital and healthcare entities from reselling their pharamaceuticals
Omnibus Budget Reconciliation Act (OBRA) 1987
Established revisions to Medicare & Medicaid
Put more requirements in place at long-term care facilities
required services of a consultant pharmacist
Anabolic Steroid Act 1990
Enacted harsher penalties for abuse of anabolic steroids
Omnibus Budget Reconciliation Act (OBRA) 1990
Established 3 esssential components:
Prospective DUR
Retrospective drug use review
Educational programs
Counseling by Pharmacist
Food and Drug Administration safe Medical Devices Act of 1990
All medical devices are to be tracked and records maintained
Dietary Supplement Health and Education Act (DSHEA) 1994
Herbal products are dietary supplements rather than drugs
Manufacturers are NOT allowed to make claims of cure for diseases
Health Insurance Portability Act (HIPAA) 1996
Improve portability and continuity of health coverage
Establish conditions on disclosure of PHI
Patients are entitled to a complete discussion of health care options
Training must be given to employees
Food and Drug Modernization Act of 1997
Required all manufacturers & repackagers to register with FDA for products deemed “misbranded”
Label for Legend shortened to “RX Only”
Medicare Modernization Act 2003
Introduced an entitlement benefit for prescriptions
(Medicare part D)
Created Tax free savings accounts for pharmaceutical purposes
Combat Methamphetamine Epidemic Act 2005
Placed Pseudoephedrine, ephedrine, and phenylpropanolamine to the category “schedule listed chemical products” product must be sold behind RX counter
Requires Picture ID/ must be 18 yoa/ provide information
Patients allowed only 3.6 g per Day & 9g in a 30 day period
Patient Protection and Affordable Care Act 2010
Required all people to sign up for insurance coverage
Patients could not be denied coverage because of a pre-existing conditions
Many other regulations put into place dealing with insurance coverage.
UNDERSTANDING PHARMACY TECH MATH CONCEPTS
One of the most fundamental math concepts that every pharmacy technician needs to know is the definition of a percent. I know most of us have a general idea of percents. When we achieve a 95% on an exam of 100 questions, then we correctly answered 95 out of 100 questions. If we receive a 90% on an exam of 50 questions, then we correctly answered 45 out of 50 questions. To get the answer, we divide 45 by 50 and we get 0.9 or 90%. This, so far, is probably something most of us already understand. What about 2.5% hydrocortisone cream or 0.9% sodium chloride solution? What do these percents of medication mean?
In the case of 2.5% hydrocortisone cream, it is a solid (versus being in a solution). This means that the percent is weight in weight. We now know that the cream is 2.5 parts hydrocortisone in 97.5 parts of other stuff (inert ingredients also known as excipients). This is typically expressed in grams or (g). Therefore, if you had 100 grams of 2.5% hydrocortisone cream, then you have 2.5 grams of hydrocortisone and 97.5 grams of a cream base and other excipients. If you had 30 grams of hydrocortisone cream, you would multiply 30 grams by 0.025 (or 2.5%) to obtain 0.75 grams of hydrocortisone and 29.25 grams of cream base and other excipients.
In the case of the 0.9% sodium chloride solution, it is a liquid. This means that the percent is weight in volume. Always consider a percent that is in a solution as grams per 100 milliliters (mL). Our 0.9% sodium chloride is 0.9 grams per 100 mL. People seem to always forget the 100 mL part. There are many calculations where you need to know the concentration in milligram (mg) per mL or gram per liters (L). You could do the simple algebra equation below:
Converting percent to mg/mL
0.9 g/100 mL = x mg/mL
(we can add 1000 mg/1 g because they equal each other)
x mg/mL = 0.9 g/100 mL X 1000 mg/g = 9 mg/mL
Converting percent to g/L
0.9 g/100 mL = x g/L
(we can add 1000 mL/1 L because they equal each other)
x g/L = 0.9 g/100 mL X 1000 mL/L = 9 g/L
Now that you know the actual calculations, you can use a shortcut. Whenever you need to convert a percent to g/L or mg/mL, simply move the decimal to the right by one place. In the case of 0.9%, this means it become 9. You probably noticed above that both answers are 9. This is a fundamental mathematical skill that all pharmacy staff (pharmacists and pharmacy technicians) needs to know. Commit it to memory, and it will serve you well throughout your career.
PTCB EXAM MATH SIMPLIFIED
Most students cringe when they think about liquid & solid dilutions. That’s because most text books make this unnecessarily complicated and frustrating. Let’s take that headache away by understanding some simple concepts.
Firstly, we can NOT change the strength, or concentration, of a preparation by simply adding more of it. Instead, we have to add some type of diluent, solvent or inactive ingredient to accomplish this (such as distilled/sterile water, lanolin, etc.). Secondly, adding this diluent results in a liquid solution or solid medication with a lowerpercent strength. From our last module, we learned that percent strength describes the amount of drug (in grams or mL), in exactly100mL of solution — or similarly, grams of drug per 100g of solid. Always remember that this amount of drug is part of the total volume of solution/solid, NOT in addition to it. Lastly, these are DILUTION problems. This means we’re ADDING diluent/solvent, NOT SUBTRACTING it (at least not when it comes to the exam). In a future module, we’ll learn about a similar concept called, alligations. The formulas we’ll use for dilutions are:
1. Initial Volume x Initial Strength = Final Volume x Final Strength
V1 × S1 = V2 × S2
V1/S2 = V2/S1
2. Initial Quantity x Initial Strength = Final Quantity x Final Strength
Q1 × S1 = Q2 × S2
Q1/S2 = Q2/S1
The volumes/quantities need to have the same units: L, mL, g, mg, etc. Furthermore, when using these dilution formulas, we’re allowed to input the percent strengths as whole numbers. We don’t have to convert the percent strengths to decimal fractions. Now Let’s have a deeper look with some real examples.
Let’s say we have a 1.2L (1,200mL) bottle of 23% calcium gluconate solution and are out of stock of 10% calcium gluconate solution because GASP — the delivery van forgot to bring it! Well, we may be ticked off but you know what? We can fix this problem by doing some extemporaneous compounding! Assuming we use the entire bottle for the initial volume (like a boss), then we can figure out how much diluent we need to add by setting up the formula with the following variables:
1,200 mL × 23% = (x) mL×10%;
1,200 mL × 23% / 10% = (x) mL;
1,200 mL × 20% / 10%
= 2,760 mL 10% calcium gluconate
But wait, we’re not done yet! Since 2,760mL is the final volume this means that we need to qs ad 1,560mL sterile water, the difference between the initial and final volume:
2,760 mL − 1,200 mL
=1,560 mL sterile water
Now let’s say we traveled back in time (because we’re cool like that), and before we decided to empty the pharmacy’s last bottle of 23% calcium gluconate, we received a prescription that calls for a 96 dram (6 oz or 355mL) vial of 10% calcium gluconate solution. In other words, instead of starting with an initial volume of 23% calcium gluconate, this time we are going to initialize our formula with a final volume of 10% calcium gluconate instead. So let’s plug in our values and solve for the initial volume of 23% calcium gluconate solution:
(x) mL × 23% = 355mL×10%
(x) mL = 355mL×10% / 23%
355mL × 10% / 23%
=154mL 10% calcium gluconate
Finally, always remember to take the difference of the two volumes to obtain the amount of solvent added (in this case, sterile water):
355mL − 154mL
= 201mL sterile water
To solidify your knowledge of liquid & solid dilutions I will prepare more practice questions in the coming weeks.
let’s look at 2 more examples. What is the final volume of a 70% alcohol solution produced by diluting 2 pints of 91% alcohol? Since the units must match, let’s first convert 2 pints to mL and then proceed as usual:
2 pt × 473.176 mL / 1 pt
= 946.353 mL
946.353 mL × 91%
= (x) mL × 70%
946.35 mL × 91% / 70% = (x) mL
946.353 mL × 91% / 70%
=1,230.3 mL 70% alcohol
Okay let’s do 1 more. This time we’ll work with a cream. How many g of ointment base should be mixed with a 2.5% Hydrocortisone cream to prepare 1 oz of 1% Hydrocortisone cream? Well, let’s first convert 1 oz to g and then proceed as usual
1 oz × 28.349 g / 1 oz = 28.349 g
(x) g × 2.5% = 28.349 g × 1%
28.349 g × 1% / 2.5% = (x) g
28.349 g × 1% / 2.5 %
= 11.3 g of 2.5% HC cream
28.349 g − 11.3 g = 17.0 g ointment base
IMPORTANT GUIDE AND CHEAT SHEET ON PTCB MATH
SAMPLE MATH QUESTIONS AND ANSWERS FROM PTCB EXAM QUESTION BANK TO SOLIDIFY YOUR MATH SKILL
FREE PTCB STUDY GUIDE
FREE PTCB EXAM GUIDE
PTCB ABBREVIATIONS GUIDE
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