Pharmacy Technician

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Delmar is a division of Thomson Learning. The Thomson Learning logo is a registered trademark used herein under license. Printed in the United States of America 1 2 3 4 5 6 7 8 9 10 XXX 04 03 02 01 00 99 For more information, contact Delmar, 3 Columbia Circle, PO Box 15015, Albany, NY 12212-0515; or find us on the World Wide Web at http://www.delmar. com All rights reserved Thomson Learning © 2000.

The text of this publication, or any part thereof, may not be reproduced or transmitted in any form or by any means, electronics or mechanical, including photocopying, recording, storage in an information retrieval system, or otherwise, without prior permission of the publisher. You can request permission to use material from this text through the following phone and fax numbers. Phone: 1-800-730-2214; Fax 1-800-730-2215; or visit our Web site at http://www. thomsonrights. com Library of Congress Cataloging-in-Publication Data Anthony, Patricia K.

Delmar’s pharmacy technician certification exam review / by Patricia K. Anthony p. cm. Includes bibliographical references and index. ISBN 0-7668-0743-6 1. Pharmacy technician’s examinations, questions, etc. 2. Pharmacy technician’s outlines, syllabi, etc. I. Title. II. Title: Certified pharmacy technician examination review. [DNLM: 1. Pharmacists’ Aides Examination Questions. 2. Pharmacy Examination Questions. QV 18. 2 A628d 1999] RS122. 95. A585 1999 615′. 1’078—dc21 DNLM/DLC for Library of Congress 99-25102 CIP Contents Preface Acknowledgments Introduction vii viii ix Section I Chapter 1.

Assisting the Pharmacist in Serving Patients Receiving the Medication Order The Medication Order The Medication Administration Record Comparison of Medication Orders in Retail and Institutional Settings Processing the Medication Order Basic Terminology—The Dosage Form and Instructions Routes of Administration Interpreting the Order Dispensing the Correct Medication Comparison of Drug Dispensing in Retail and Institutional Settings Preparation and Utilization of the Patient Profile Obtaining and Entering Patient Information Comparison of Patient Profiles in Institutional and Retail Settings Handling Medications Use of the Manufacturer’s Label to Correctly.

Dispense Medication Packaging and Labeling the Medication Dispensing Liquid Medications Intravenous Admixtures and Injections Auxiliary Labels Proper Storage and Delivery of Drug Products Storage Conditions Preparation of Unit Doses Use of Pharmacy Inventory as Floor Stock 1 3 5 9 11 15 16 17 18 23 23 27 28 30 35 36 37 38 41 42 45 46 48 49 Chapter 2 Chapter 3 Chapter 4 Chapter 5 iv Contents Chapter 6 Receiving Monetary Compensation for Goods and Services Methods of Payment for Pharmacy Services Profit and Markup.

53 53 55 Section II Chapter 7 Inventory Control Stocking the Pharmacy The Drug Formulary Ordering and Receipt of Drug Products and Devices Ordering Regular Drugs and Devices Maintenance of Drug Products Maintenance of Drug Products in Inventory Importance of Proper Storage of Drug Products in Inventory Handling Expired Medications and Drug Recalls Drug “Recapture” Commercial Calculations Cost and Markup 57 59 59 60 61 65 65 66 66 67 71 71 Chapter 8 Chapter 9 Section III Pharmaceutical Calculations.

Chapter 10 Fractions, Decimals, and Algebra Review Dividing a Whole: Using Fractions Working with Decimals Use of Algebra in Pharmaceutical Calculations Rounding Numbers Using Roman Numerals Systems of Measurement Common Systems of Measurement Ratios Temperature Conversions Using Percentages and Ratios Percentage as Parts Per 100 Using Alligation Using Drug Concentrations Expressed as a Ratio Measuring Equipment Liquid Measurement Measuring Solids Conversion of Solid Dosage Forms Converting Between Measurement Systems.

75 77 78 80 82 82 83 85 85 89 90 93 93 95 96 101 102 105 109 111 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Contents v 115 115 123 123 125 126 126 131 131 132 137 137 143 143 149 149 153 153 159 Chapter 15 Chapter 16.

Conversion of Liquid Dosage Forms Converting Between Liquid and Solid Dosage Forms Pediatric Doses Computation of Pediatric Doses—Differences from the Adult Dose Computation of Dose by Body Surface Area (BSA) Young’s Rule and Clark’s Rule Recommended Daily Doses (Safe Dose) Parenteral Dosages Parenteral Dosage Forms Calculation of Parenteral Doses Intravenous.

Calculations Administering Intravenous Medication—The IV Drip Intravenous Admixtures Infusing Medications Over Time—The IV Drip and Admixture Calculation of Dose per Time Calculating the Amount of Drug Infused per Time (Dose per Time) Bulk Compounding Compounding Drugs by Procedure Math Test with Solutions Chapter 17 Chapter 18 Chapter 19 Chapter 20 Chapter 21 Chapter 22 Section IV Pharmacy.

Operations Chapter 23 Safety in the Workplace Occupational Health and Safety Administration Regulations Disposal of Hazardous Waste Sanitation Management Spills Using Computers in the Pharmacy Use of Computers in Pharmacy Practice The Components of a Computer Communications Within the Pharmacy Role of the Technician in Communication Role of the Pharmacist in Communication 169 171 171 172 173 173 177 178 178 183 183 184.

Chapter 24 Chapter 25 vi Contents Section V Chapter 26 Pharmacology Drug Nomenclature Introduction Proprietary Drug Nomenclature Drugs That Affect the Central Nervous System Drugs That Affect the Cardiovascular System Drugs That Increase Pulmonary Ventilation Drugs Used to Relieve Allergies (Antihistamines) Drugs That Affect the Gastrointestinal System Drugs for Use in Parasitic Infections Drugs That Affect the Endocrine System Drugs That Affect the Reproductive System Drugs Used for Infection The Pharmacology of Drug Interactions Ways In Which Drugs Can Interact Drug Toxicity and Interactions Drugs That Affect the Autonomic Nervous System 187.

189 189 190 191 197 203 204 205 206 206 207 209 217 217 219 222 226 227 231 249 269 Chapter 27 Suggested Reading Appendix A Look Alike and Sound Alike Drugs— Avoiding a Fatal Error Appendix B Pretest with Answers Appendix C Sample Examination and Answer Sheet;

Answers for Scoring Index Preface One of the most rapidly growing fields today is pharmaceutical therapeutics. This rapid growth has created opportunities for a variety of welltrained technical personnel: physician’s assistants, medical assistants, nursing assistants, and pharmacy assistants. In fact, one of the most rapidly expanding positions is that of the pharmacy assistant—now called, in most states, the pharmacy technician.

The growing demand for these trained technical personnel is due, in large part, to the rapidly expanding area of drug research and drug discovery. The pharmacist simply does not have enough time to keep up with recent advances in drug therapy and new dosage delivery systems, and counseling patients and physicians, in addition to the other duties such as drug dispensing, ordering, and the record keeping which is required by law.

This need for well-qualified technicians to perform sophisticated duties has created the requirement for a standardized examination to ensure that the technicians working within a pharmacy uphold an acceptable level of knowledge and integrity.

Thus, a national examination for the certification of pharmacy technicians has been created to replace state certification examinations. The Pharmacy Certification Training Board (PCTB) administers this examination for certification of pharmacy technicians (CPhT).

The high standards and increasing difficulty of this examination have created a need for a text which, in addition to being useful for the student of pharmacy technology, will address the main features of the examination, providing information, a comprehensive review, and a basis for understanding the concepts addressed in the examination. Delmar’s Pharmacy Technician Certification Exam Review was written to fill this need.

This text was designed for a twofold purpose: to function as a review for technicians familiar with the material and to serve as a learning tool both for students of pharmacy technology and for technicians who have been trained to perform a limited number of duties (such as within a retail pharmacy). These technicians must now become familiar with broader concepts, such as pharmacology and advanced pharmaceutical calculations, in order to become certified. The text is written in conversational style, to facilitate understanding of difficult concepts among many levels of readers.

Foremost in the text is an examination of the routine procedures in the pharmacy: accepting viii Preface prescriptions, creating patient profiles, processing and filling prescriptions, and maintaining inventory. This portion of the text covers procedures in both the retail and institutional pharmacy settings, and provides comparisons between them. Special care has been taken to discuss not only the procedures themselves but the reasoning behind the procedures—why are they done in a particular way?

This approach is not only necessary to understand work within a pharmacy but is critical to doing well on the certification examination. A large block of chapters dealing with pharmaceutical calculations has also been provided, which covers a large variety of types of calculations that will appear on the examination.

These have been presented in a simple, easy-to-understand manner, designed to take the fear out of math. Topics include not only simple dosage conversions but intravenous calculations, pediatric dosages, compounding, and commercial calculations, as well.

All math problems are followed by a section containing the correct answers and a detailed explanation of the reasoning and calculations leading to the correct answer. An entire chapter consisting only of math problems, with answers and worked-out solutions, is included as well. Among the review material provided, the text contains a pretest, which will assist the reader in prioritizing material to review and study.

Each chapter begins with a “Quick Study,” a concise summary outline of the material within the chapter, which is designed to accommodate readers at different levels of knowledge. In addition, each chapter contains questions or problems to be worked out, with detailed solutions and answers, which will help the reader understand the thought processes that are crucial to understanding and correctly answering the questions on the examination.

Finally, a sample examination is included, with standardized answer sheets, such as those which will be used for the examination. The author of Delmar’s Pharmacy Technician Certification Exam Review, Dr. Patricia Anthony, is a practicing pharmacologist with advanced degrees in biology and pharmacology, and bachelor’s degrees in biology and pharmaceutical science.

In addition, she holds a doctorate in pharmacology from New York Medical College. Before devoting full time to teaching and research, Dr. Anthony devoted full time to medical research as postdoctoral faculty within Harvard Medical School in Massachusetts.

Acknowledgements The author wishes to thank the reviewers, and especially thanks Mrs. Judie Kautz and Mr. John Carbonaro for their efforts, which made the production of this text possible. Introduction About the PCTB Examination Structure of the Examination The PCTB examination consists of 125 multiple choice questions. It is a timed test, which lasts for three hours. This means that you must pace yourself in answering the questions.

There are three general areas in which competency will be assessed: 1. Assisting the pharmacist in serving patients. This portion includes interpretation of the prescription order; construction and use of the patient profile; and dispensing, labeling, storage, and delivery of medications.

Also included are pharmaceutical calculations: dosage conversions, intravenous medications, IV admixtures, dose per time, and commercial calculations. These questions will make up 50% of the exam (about 60–70 questions). Both hospital and retail settings will be covered, and the student will be expected to know the differences in procedures between the different settings.

The questions will require you to think about why you are doing things a certain way as well (with responsibility comes challenge). For example, why is certain information required on the prescription order and profile? Why do we have the patient profile? Why do we use aseptic technique when preparing intravenous medications? This book will train you to think about these things as you answer the questions. 2. Medication distribution and inventory control.

This portion addresses how the medication is stored in the pharmacy, the ordering and inventory process, prepackaging and unit dose distribution, labeling, and record-keeping. These questions will make up 35% of the exam (40–50 questions). x Introduction 3. Pharmacy operations.

This section addresses safety concerns, cleanliness, infection control, pharmacy law, communications, and automation (e. g. , computers). These questions make up 15% of the exam. Taking the Examination You should read the booklet which came with your application carefully. It contains a lot of useful information, such as the location where the exam will be given and what you should bring with you.

You should also be aware that the actual examination will not simply test on memorized information. Questions and problems will require the student to think and synthesize information. It is also helpful if you know how to take the test (see below).

When using this text to prepare for the exam, bear in mind that the certification examination is now a national examination, and, since laws vary from state to state, information that may be considered correct for the examination may not be exactly the same as what you have learned in practice.

Answering Questions on the Examination Since the test is in multiple choice format, you must know how to take multiple-choice tests. You will not know all of the information; however, you can use what you do know to choose the correct answer. Perhaps a question asks which of the following drugs is a diuretic. The potential answers are: streptomycin, penicillin, tobramycin, and mannitol. You panic, because you have no clue. Instead, you should look carefully at the answers, bearing in mind that only one is correct.

Everyone (hopefully) knows that penicillin is an antibiotic. Scratch that one. Two of the answers end in the same thing: streptomycin and tobramycin. It is likely that they do similar things. The only one that is left is mannitol, which happens to be the right answer. If you take the time to look at the question and all of the answers given, before you panic, and think your way through the problem, using the knowledge that you do have, it is time well spent. Another thing which you must do is to read the question carefully. Ask yourself “What is the question asking? ” Then, if you can, answer the question in your head before looking at the answers. If you do not, the answers will confuse you.

A standard way of making up multiple choice tests is to ask a question and then think of all of the ways a student could interpret the question, or the mistakes which could easily be made, and then make the incorrect answers from that. It is not that the exam is unfair; the questions are simply testing your knowledge and that includes Introduction xi the ability to distinguish fine points. So always answer the question first in your head, and then look for your answer in the choices.

Do not let the questions or answers intimidate you. Let’s say you are answering a math problem. You come up with an answer and find it in the list, but the other answers are the same as yours, except for a zero or decimal place. If you did the calculation correctly, your answer is correct. Do not second-guess yourself.

More wrong answers are made on exams because students get nervous and change their initial (correct) answer to another (incorrect) answer. You have prepared for this exam—act like it! Have confidence in what you can do. Don’t panic! This exam, like many standardized exams, does not have one passing score.

The passing score is different for each exam, because the people who make up the questions assign a difficulty rating to each question, and the average difficulty rating for all of the questions on a particular exam determines the passing score. Thus, the passing score for an exam given in one session will not be the same as another, as the examinations vary in difficulty. Bear this in mind, and if the questions seem to be extremely difficult, don’t despair.

This may mean that the passing score is lower as well. Just don’t panic—just attack the exam logically. Preparing for the Examination First, take the “pretest” to determine which sections of the book to review first.

There is a “Quick Study” guide at the beginning of each chapter for quick review. Study this first, then read through the chapters for approaches to thinking and important details. Then, as you continue to go through the book, practice doing the problems in each section, even if they seem too easy or hard. The answers are explained for you, so use these to channel your thinking about how to approach the questions in a certain way.

Ask yourself questions about the material, and see if you can come up with the answers either on your own or from the text material. Ask why! Finally, take the practice test. When you take the practice test, you will sit in a room with conditions which may not be the best for you.

The examination center may not be as warm or as cool as you like, and there will be many other people there who will be making at least a small amount of noise (excessive erasing, drumming fingers or tapping feet, clearing throats, heavy breathing, etc. ). I once took a standardized exam next to a student who started with finger drumming, progressed to slapping his feet on the floor, and then [unbelievably] to belching, all simply because he was nervous.

Practice concentrating under these conditions—anyone can concentrate in a climate-controlled, comfortable, quiet room! If you can do well under the worst conditions, you will do even better should the conditions be the most favorable for you. If possible, have some others next to you when xii Introduction taking the practice test. These exams are often in close quarters.

Finally, grade the exam, using the answer key. Determine which questions you missed and why. Study those parts again. Now you have prepared for most things which can come your way (one can never be prepared for everything—that’s where the thinking part comes in). You are ready to take the exam. Before the Examination–Helpful Hints Get a good night’s sleep before the exam.

Know where the exam is to be held, exactly how to get there, and where to park. Make a dry run, in order to find out how much time it will take you to get there, park, and get to the examination room, then add an extra few minutes This way, when the test day arrives, you will be there on time with a minimum of frustration. Get adequate nutrition before the exam. Remember—the brain runs on glucose.

If you do not feed it, it will not work. So, on the morning of the exam, be sure to eat a good breakfast, even if you are not hungry. This is more important than you might think! Avoid drinking a lot of coffee; substitute juices instead. You have prepared, so you should not be nervous.

If you are, try looking over the section outlines in the book or notes that you have taken for yourself. If it all looks too familiar, you should be ready. Good luck! S E C T I O N I Assisting the Pharmacist in Serving Patients Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6.

Receiving the Medication Order Processing the Medication Order Preparation and Utilization of the Patient Profile Handling Medications Proper Storage and Delivery of Drug Products Receiving Monetary Compensation for Goods and Services Chapter 1 Receiving the Medication Order Quick Study (See text for full explanation. ) I. Written prescriptions: the prescription blank A.

Required information at time of acceptance—written in ink or typed on the prescription form • • The patient’s full name Date of issue of the prescription: regular prescriptions are valid for one year; prescriptions for controlled substances (Schedule II–V) are valid for as little as three days, depending on the state of issue.

The name and title of the prescriber The Drug Enforcement Agency (DEA) number assigned to the prescriber: a seven-digit number, beginning with two letters, denoting the status and last initial of the prescriber The name of the drug prescribed (generic or brand name) Strength and dosage form of the drug prescribed (see exceptions) Quantity of drug to be dispensed Instructions for dosage (SIG) Instructions for labeling Signature of the prescriber, in ink Authorization to dispense a generic substitution: required for substitution of proprietary label only.

When “dispense as written” (DAW) designation is present, there is to be no substitution of any kind Refill information: 1. Must be clearly written in (or the number of refills circled) on the form 2. Refill authorization: an extension of the original prescription.

This is the responsibility of the pharmacist Instructions for preparation of the drug: detailed instructions must be given for preparation; otherwise, it is considered extemporaneous compounding, and must be done by the pharmacist • • • • • • • • • • • 4 Chapter 1 B. Information to be added to the prescription form at time of acceptance • • • • • • • • • •

The address and telephone of the patient: to identify the patient and assist in medication recalls Age or date of birth of the patient: to identify the patient and clarify proper dose Allergies and concurrent medications: to prevent potential drug interactions, adverse effects, and therapeutic duplications The insurance coverage of the patient Verification of medication and amount prescribed, signature verification Verification of DEA number All information must be present on triplicate form: no writing on the form is allowed No corrections, writeovers, or extra writing should ever be present C.

Authentication and clarification of the order D. Accepting prescriptions for controlled substances II. Prescriptions received by electronic means (telephone, fax machine, or modem) Accepted by licensed practitioner (i. e. , pharmacist, intern, nurse) only Prescription must be immediately transcribed onto a “hard copy” III. Medication Administration Record (MAR) A.

Structure and use of the MAR • • • • • • • • • • It serves as a drug order in an institutional pharmacy It is much more detailed than the paper prescription Information presented may include patient location, billing number, diagnosis, height, weight, medical tests, diet, and medical history Regular medications are ordered by administration schedule, according to the twenty-four hour clock It may include directions for use of medications and/or instructions for compounding The organization of the MAR differs from that of the paper prescription.

The initiation of drug therapy and discontinuation are specified Calculation of the amount of drug required per dose (unit dose) Preparation of the correct amount of drug in the correct vehicle for delivery Preparation and placement of the appropriate label, showing the patient name, location, drug name, quantity, expiration date, attending physician’s name, and instructions (if any)

Placement of the prepared unit dose into an appropriately labeled cassette Differences in amount of detail presented: instructions, dosing schedules, etc. B. Executing the MAR • • C. Comparison of medication orders in retail and institutional settings Receiving the Medication Order 5 • • • • •

More detailed identifying information presented on the MAR: helps ensure the administration of drugs to the proper patient More information is present on the MAR: laboratory tests, diet, etc. Concurrent medications are normally not recorded on the MAR: intake of both food and drugs are more strictly regulated in an institutional setting DEA numbers of individual prescribers are not required Special documentation for controlled substance prescription is not required on the MAR The Medication Order In a retail pharmacy, the medication order (prescription) is written on a form which is normally preprinted with certain information. If the required information is not preprinted, it may be written or typed on the form.

The written medication order must be written in ink or typed, to avoid possible alteration, and must contain the following information when received in the pharmacy. If the prescription is incomplete or illegible it cannot be filled, and the patient should be referred back to the prescriber or to the pharmacist. Information on the upper portion of the prescription form must include the following: • •

The patient’s full name: This is required for positive identification. The date of issue of the prescription: The date of writing helps to determine if the prescription may be filled. It should be noted that the laws regarding prescription filling do vary from state to state.

However, since the certification exam is based on federal laws, the normal rule of thumb to remember is this: regular prescriptions are valid only for one year after being written, and prescriptions for controlled substances are valid for only three days. If the date of issue is past the date of acceptance (i. e. , one year), the prescription cannot be filled. The name and title of the prescriber: the prescriber may be a doctor of medicine (MD), osteopathic medicine (DO), optometry (OD), dentistry (DDS), veterinary medicine (DVM), or podiatry. Other individuals licensed to prescribe drugs may include the physician’s assistant and nurse practitioner.

The DEA number of the prescriber: The DEA number is a sevendigit number issued to the prescriber or institution by the Drug Enforcement Agency. It should begin with two letters. The first letter designates the status of the prescriber (e. g. , MD, DO, or nurse practitioner). The second letter is the first letter of the prescriber’s last • •

6 Chapter 1 name. Thus, it is easy to check the validity of the prescription: if the prescriber’s name is Smith, for example, and the DEA number starts with AU, it is invalid. A valid DEA number can also be checked by adding the first three odd-numbered digits (the first, third, and fifth numbers) to the sum of the even-numbered digits (the second, fourth, and sixth) multiplied by two.

The last digit of this number should be the same as the last digit of the prescriber’s DEA number. The authenticity of the prescription can thus be verified by comparing the letters in the DEA number against the name and status of the practitioner, and by numerical calculation. On the body (middle part) of the prescription you should find all of the following (see Chapter 2 for discussion): • • • •

The name of the drug prescribed (generic or brand name). Strength and dosage form of the drug prescribed (e. g. , 10 mg tablets). Quantity of drug to be dispensed (e. g. , 10 tablets, 50 ml). Instructions for dosage (SIG): These should be clear and understandable.

(See Chapter 2 for a discussion of dosage instruction interpretation. ) Instructions for labeling: The prescriber may not want all of the information on the prescription form to be shown on the label. In this case, instructions as to what information is to be printed on the label are included. Signature of the prescriber, in ink: no prestamped facsimiles are acceptable.

Authorization to dispense a generic substitution: The way in which generic substitutions are authorized or disallowed varies from state to state. Some states have an open box printed on the prescription form in which the prescriber writes the letters DAW, if the prescription is to be filled exactly as written.

In other states, the prescription blank has two lines for signature, and the line on which the prescriber signs designates how the prescription is to be filled (see Chapter 2 for further discussion of generic substitutions). Refill information: The number of refills should be clearly designated on the prescription form. Instructions for the preparation of a drug:

This is rarely seen on a paper prescription; however, if a drug needs to be made a certain way, such as in a cream or suppository instead of a tablet, the prescriber may write out instructions for preparation of the drug. If specific, written instructions exist for preparation of the drug, it may be prepared by the technician; otherwise it is called extemporaneous compounding (see Chapter 21) and must be done by the pharmacist. • • • • • Receiving the Medication Order 7

There is some information which is necessary for the pharmacy to have, in order to protect the patient (and also to protect the pharmacy from liability). This information may be obtained by the technician and written on the prescription form, if the prescription is for a regular prescription drug. If the prescription is for a Schedule II drug, such as morphine, meperidine (Demerol), or oxycodone (Roxicet), all information must be complete before acceptance at the pharmacy window.

There should be no blank spaces, incomplete information, writeovers or corrections of any kind. Information which may be placed onto a regular prescription form at the time of acceptance includes the following: • • • • The patient’s address and telephone. Age or date of birth. Allergies and concurrent medications.

The insurance coverage of the patient: How does the patient intend to pay? This might be in cash (self-pay), by co-pay (billing the insurance company directly), or receipt for reimbursement, for example. Accepting Refill Requests Refill requests for prescriptions other than Schedule II drugs may be made by the patient. These may be made over the telephone or in person.

These requests may be accepted by the technician. Since the original prescription is assigned a number when it is filled, the patient can refer to this number for refill information. The appropriate amount of drug is then deducted from the number of remaining prescription refills, and entered into the patient profile (see Chapter 2).

Refills are normally spaced out over an appropriate amount of time; however, they may be given all at one time (at the discretion of the pharmacist) if the patient requests it. Sometimes, when the drug is taken for a long period of time (e. g. , anti-seizure drugs and anxiolytics), it is less expensive for the patient to buy larger quantities at one time.

Conversely, the patient might not be able to afford the entire quantity of drug prescribed and may be allowed to only purchase part of the prescription at a time. These changes are made at the discretion of the pharmacist, as the pharmacist is legally responsible for all that happens in the pharmacy. Controlled substances, especially Schedule II drugs, are treated in a very different way. These drugs may be filled by the technici.

1. What are the requirements for dispensing schedule II and III prescriptions? Name some examples of each. Schedule II can only be prescribed in person, unless it’s an emergency. Schedule II’s dispensing is very strict since it has a high …

A. C. E. Inhibitors – Angiotensin Converting Enzyme Inhibitors block the conversion of angiotensin I to angiotensin II. Avoiding Angiotensin II may avoid increased blood pressure and vasoconstriction. They usually have the suffix “PRIL” A. 2. R. B. – Angiotensin …

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