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Instructor: Milan Topalov
Fall Session, 2012
Instructor Credentials
 Education:
 St. John’s University, Jamaica, N.Y. : Bachelor Degree in
Chemistry cum laude. Awarded 1997 . Curriculum included
organic synthesis, functional group analysis, and other chemical
theory study.
 St. John’s University, Jamaica, N.Y.: Pharm.D in Pharmacy, cum
laude. Awarded in 2006. Curriculum included required NYS
pharmacy study: pharmacology, pharmacokinetics, therapeutics,
pharmacy law.
 Professional Licensure: NYS licensed Pharmacist (RPH):
licensed October 2006
Employment History:
 New York Presbyterian Hospital at Columbia / Cornell
622 W. 168th Street, New York, N.Y. 10032
Title: Pharmacist
Duties as Pharmacist:
medication review and order entry,
drug information consultation for MD and RN
supervision of pharmacy personnel
IV admixture preparation
Omnicell and Pyxis experience
Held: January 2008- Present.
Flushing Hospital Medical Center, Flushing NY
Title: Pharmacy Intern. Held between December 2002-October, 2006
Title: Pharmacist. Held between October 2006-December 2007
Duties as Pharmacist:
medication review and order entry,
drug information consultation for MD and RN
supervision of pharmacy personnel
IV, TPN, and chemotherapy admixture preparation (limited experience)
History of Pharmacy
 Babylon around 3,000 BC provides the first example of
the pharmacy practice.
Pharmacists were priests, doctors, and philosophers
Ancient Egypt had two classes of pharmacy workers:
echelons and fabrication chiefs. Papyrus Ebers is a
collection of over 700 unique drugs.
Terra Sigilata or “sealed earth” was the first
trademarked medicinal agent.
Hippocrates was a greek physician who lived during
Plato's time. Physicians today profess the Hippocratic
oath to “do no harm”.
 Late in the eighth century, Arabs separated the professions
of medicine and pharmacy.
 America’s Pharmacy History
 John Winthrop, governor of the Massachusetts Bay Colony,
was consider America’s first pharmacist.
Philadelphia Hospital was founded in 1751.
University of Pennsylvania College of Pharmacy formed in
American Pharmaceutical Association formed in 1852.
United States Pharmacopoeia (USP) published in 1820
became America’s first official drug compendium.
American Council on Pharmaceutical Education in 1932
established education standards for the pharmacy profession.
Definition of Pharmacy Technician
 A pharmacy technician is an individual who is trained
to perform certain tasks related to providing pharmacy
services to patients in an institutional setting and
customers in a community setting.
 A pharmacy technician is an important part of the
pharmacy team who directly assists the pharmacist in
the provision of pharmaceutical related care.
 The expanding role of the pharmacy technician has
enabled the pharmacist to spend more time in
providing clinical services to patients.
Duties performed by a pharmacy
 The duties performed by a pharmacy technician vary
according to the state that the technician is employed.
 The duties typically involved the physical act of medication
 Technicians in most states can:
 Provide purchaser services and place orders for medications
to suppliers.
Physically fill and handle automated dispensing cabinets (i.e
pyxis and omnicell)
Assist in Inventory management.
Count, pour and label medications for patients
Pre pack medications from manufacturer s to institutional
generated packaging.
Duties performed by a pharmacy
technician (continued)
 In NY state a pharmacy technician is allowed to accept
written prescriptions presented to the pharmacy by
patients and gather patient specific information.
 A pharmacy technician is allowed to key personal
prescription data into a computerized system; however
a licensed pharmacist must initial and approve the
 A pharmacy technician is allowed to handle issues
dealing with pharmacy third party payers.
Duties that a pharmacy technician
can’t provide.
 In all states, a pharmacy technician can not provide counseling
to patients or provide drug information to other health care
professionals (i.e MD’s and RN’s).
In some states, a pharmacy technician can not accept oral orders
for prescriptions from health care providers authorized to
prescribe drugs (MD, NP, PA)
A pharmacy technician is not permitted to compound
medications like creams, ointments, and parenteral agents. (This
is in NY ; however, others states differ)
All these duties are the responsibilities of the pharmacist or a
pharmacy intern.
In general, any issue that involves professional judgment
requires the pharmacist. Performing these duties can leave you
open to legal liability.
Requirements to be a pharmacy
18 years of age.
High school diploma or GED
No Felony convinction
The above requirements will allow you to be able to take
the PTCE which is the Pharmacy Technician Certification
Board’s (PTCB) exam
 The above requirements will allow you to be able to take
the ExCPT which is given by Institute for the Certification
of Pharmacy Technicians (ICPT).
 The website for the PTCB is
 The website for the ICPT is
Certification versus Licensing:
difference between a pharmacy
technician and a pharmacist
 A license is granted to a pharmacist by the state in which
he/she is employed.
 A certification is granted by a nongovernmental agency
that indicates an individual has obtain a certain level of
competency in the field in which the certification is
 States and employers recognize these agencies and often
attach highest priority to these individuals possessing
 Many states require these certifications to allow individuals to
be registered as pharmacy technicians.
 Some employers require these certifications for consideration
in employment.
The Pharmacist: background
 A pharmacist is an individual licensed to dispense, compound, and provide
drug related advise on medications.
 A pharmacists can work in a community/retail setting, hospital or institutional
setting or in the pharmaceutical setting for drug companies like Pfizer or
Sanofi Aventis. Opportunities in these areas exist for the pharmacy technician
as well.
 To be a pharmacist requires:
 Six years of study in a college of pharmacy to include organic chemistry,
physiology, pharmacology and therapeutics among other course work
 9 months of internship (part of six year program)
 Graduation from the program with a PharmD. Degree
 Passage of the NAPLEX exam
 Passage of the Jurisprudence (Pharmacy Law)exam for the state in which
applicant of the license wishes to practice.
 Registration with the state in which the applicant wishes to practice.
 45 CE credits every 3 years to be able to renew registration. License is
permanent unless its revoked for professional misconduct.
NY state board of Regents and the
office of professions
 Every person that holds a professional license in NY
state has their professional record open to inspections
by a citizen of the state.
 This list includes pharmacists, doctors, lawyers,
accountant, nurses etc.
 The list, called on line verification, can be accessed at:
Pharmacy Technicians in the
hospital setting
 Duties includes: ordering of medications from suppliers, filling
orders, labeling medications, unit dosing, filling of ADC with
legend drugs and controlled substances.
 At New York Presbyterian/Columbia University Medical Center.
 Pharmacy technicians are paid between $39,000 to $42,000 per year
not including overtime.
Pharmacy technicians are 1199 union members.
Pharmacy technicians receive 4 weeks paid vacation/year, 12 paid
sick days/year, 8 paid holidays/year, and 4 personal days/year. In
addition, full time technicians are eligible for a union pension, life
insurance, full medical and dental coverage.
Pharmacy technician receive good pay for their efforts.
PTCB certification is required at NYP
With great rewards come great
 A pharmacy technician is a rewarding career and can open the
doors to other opportunities. (1199 provides CE credits free of
charge and offers tuition assistance for individuals wishing to
pursue future studies)
 However, with these benefits comes responsibilities. You will be
entrusted with people’s medications and you will be handling
medications that are controlled substances in the United States
(i.e Narcotics like Vicodin®, Percocet®, Xanax®, and stimulants
like Concerta® and mixed amphetamines like Adderall ® etc)
 In some states you will be allowed to compound medications
into IVs.
 Mistakes made can be costly and can leave you open to legal
Legal Cases involving Pharmacy
Technicians (and Pharmacists)
 “Rx for errors: Drug error killed their little girl”
 Article reported in US Today in February, 2008 about 2
year old Emily Jerry in a Cleveland Ohio hospital.
Emily Jerry’s Case
 2 year old girl was diagnosed with a curable tumor in the abdominal region of
her body in 2005. The “cure” became the curse.
 A pharmacy technician had prepared Emily’s chemotherapy medication using
23.4% solution of sodium chloride instead of the normal 0.9% sodium chloride
solution. The pharmacist who was supervising the technician had also missed
the error. The baby received the chemotherapy agent and within a few hours
was on life support. She died on March 1, 2006.
 In August 2006, an Ohio grand jury indicted the pharmacist on charges of
reckless homicide and involuntary manslaughter "in the death of Emily Jerry.“
 Ohio state board of pharmacy revoked his license.
 Unlike the pharmacist, the pharmacy technician did not face disciplinary
charges; however she no longer works at the hospital and now holds a non
pharmacy related job at CVS.
 Congressman, Rep. Steven LaTourette, R-Ohio. introduced Emily’s Act into
congress which would mandate certain educational requirements for all
pharmacy technicians and provide for restrict legal penalties for misconduct.
Legal Cases
 “Inside a pharmacy where a fatal error occurred” USA
Today article published in 2008.
 Case concerned a 46 year old man with a prescription for
methadone in 2001. He had the prescription filled at a
walgreens in Florida. He received his prescription and
began taking his medication which is a pain killer for pain.
Within a day he was found dead in the shower by his wife.
An autopsy performed determined the cause of death as a
methadone overdose.
 A legal case was brought against the Jacksonville, Florida
walgreens. The plaintiff team determined the cause as a
pharmacy technician who keyed the directions for use
incorrectly and the pharmacist who was too busy to catch
the error. The case was settled out of court.
Other cases of Pharmacy errors
 Https://
Pharmacy Technician Certification
 PTCB’s examination, called PTCE (Pharmacy
Technician Certification Exam)
 PTCB is the pharmacy technician certification board,
which began in 1995 under the organization of the
American Pharmacist Association, American Society
of Health System Pharmacist, the illinois Council of
Health System Pharmacist, and the Michigan
Pharmacist Association.
 Provides a nationally recognized standard for
pharmacy technicians
Pharmacy Technician Certification
 The PTCB’s exam that test and certifies a candidate’s
competency as a pharmacy technician
 To qualify to take the exam you must be:
 18 years of age or older
 Possess a high school diploma or GED ( a foreign diploma
equivalent may apply)at a minimum
No felony convictions
No previous criminal charges dealing with drugs
(misdemeanors also) or misconduct as defined by the NABP
Once you pass the exam you may use the acronym CPhT after
your name
Certification is valid for 2 years at which time renewal is
 Competency areas test by the exam:
 Assisting the Pharmacist in serving patients (66%)
 Maintain medication and inventory control system
 Participation in the administration and management of
pharmacy practice (12%)
 As of November 2013, the competency areas have been
slightly modified; however on balance most of the
previous material remains the same
 Visit this page for more details
 To renew a certification you must pay a fee and take 20 hours of
CE Credit
 The Structure of the Exam
 90 questions
 10 questions are polling questions that do not count towards your
score and are meant to gauge questions difficulty in reference to
future exams
 Time to complete: 1 hr. 50 min (with some extra time to complete a
tutorial and exit survey)
 The Results
 Pass/fail score is reported to you immediately on the test terminal
 Numerical score and certificate is mailed to your home
 Candidates who fail the exam are given a total of 3 tries to pass the
exam within the given application
 Application process
 Apply online: PTCB application here
 The PTCB will ask you to set up an account
 Once your application is approved you must pay the
application fee of $129
 You will receive an authorization to test notification to
schedule an exam date and time. You must schedule a
date and time within 90 days
 What is bring with you to the test?
 You
 Government issued photo ID (driver’s license)
 Candidates who don’t bring ID forfeit all fees and will
not be permitted to test
 A erasable scratch board will be provided
 Handheld and on computer calculators are provided
 All personal property (include cell phone) will be
secured at lockers at the test site
 Exam offered year round
 How is the exam graded?
 Uses the modified Angoff method
 Panel Experts estimate the difficulty in each question
and estimate the percentage of pharmacy technician
that can answer the question correctly. More difficult
questions are weighted more heavily to the overall score.
 Each exam is the compared to other exams so that
several exams of slightly fluctuating difficulties can be
scaled relative to each other. This is called Statistical
Equating (SE)
 SE produces a scale from 300 to 900 for the exam with
650 be the passing grade
 For more information please view the PCTB website
for their guidebook
 You as a pharmacy technician have a wonderful career
opportunity. You also have a great deal of
 It is your right to receive adequate supervision by your
pharmacist. Be proactive and protect yourself.
 Education is an important part of everyone’s career
path. Make it a part of yours.
 Good Luck