Question

October 2, 2010

Actually, the opposite. Allergies that I'd put up with for 40+ years disappeared 3 or 4 years before my dx. Some time after diagnosis, I began to wonder if the lymphoma had something to do with desensitizing my system to the pollens.LonFrom: Ellen <rhudy@...> Sent: Sat, October 2,

2010 10:46:27 AMSubject: question

I read a long time ago that cllers just do not get allergies. I seem to

have acquired an allergy to ragweed and pollen. It has something to do

with mast cells being activated. Has anyone else on this list acquired

an allergy years after dx.?

Thanks,

Ellen

October 2, 2010

Certainly, many CLL patients are hyper sensitive both to food and things like

insect stings etc.

There is an excellent book on the immune system that I can recommend. Probably

available in your library...

It goes into great length about IgE and allergic reactions

How the Immune System Works

By Sompayrac

~chris

>

> I read a long time ago that cllers just do not get allergies. I seem to

> have acquired an allergy to ragweed and pollen. It has something to do

> with mast cells being activated. Has anyone else on this list acquired

> an allergy years after dx.?

> Thanks,

> Ellen

>

October 2, 2010

Thanks to you and all else who responded. I USED to get mega-reactions to

mosquito bites, but in the last 2

yrs., the bites are about normal size. I've never had allergies before in my

life, and I'm 66. Wonder what's

going on. I now have classic ragweed and pollen symptoms. I will keep looking

into this. I'll check out the

book, too.

Ellen

cllcanada wrote:

> Certainly, many CLL patients are hyper sensitive both to food and things like

insect stings etc.

>

> There is an excellent book on the immune system that I can recommend. Probably

available in your library...

>

> It goes into great length about IgE and allergic reactions

>

> How the Immune System Works

> By Sompayrac

>

> ~chris

>

> >

> > I read a long time ago that cllers just do not get allergies. I seem to

> > have acquired an allergy to ragweed and pollen. It has something to do

> > with mast cells being activated. Has anyone else on this list acquired

> > an allergy years after dx.?

> > Thanks,

> > Ellen

> >

>

> ------------------------------------

>

October 2, 2010

I looked up the book on amazon.com. I was set to buy it, but then I came

across the book " Immunology

Made Ridiculously Simple. " So I ordered that one first, to solidify the basic

principles...............I know

some stuff already, but would like more basic knowledge before I buy the book

you recommended.

Thanks,

Ellen

cllcanada wrote:

> Certainly, many CLL patients are hyper sensitive both to food and things like

insect stings etc.

>

> There is an excellent book on the immune system that I can recommend. Probably

available in your library...

>

> It goes into great length about IgE and allergic reactions

>

> How the Immune System Works

> By Sompayrac

>

> ~chris

>

> >

> > I read a long time ago that cllers just do not get allergies. I seem to

> > have acquired an allergy to ragweed and pollen. It has something to do

> > with mast cells being activated. Has anyone else on this list acquired

> > an allergy years after dx.?

> > Thanks,

> > Ellen

October 2, 2010

If you want something a bit more interactive try this link...

http://immunology.medicine.dal.ca/bookcase/

It is for first year med students but it is excellent in explaining many

things related to the immune system

~chris

> > >

> > > I read a long time ago that cllers just do not get allergies. I seem to

> > > have acquired an allergy to ragweed and pollen. It has something to do

> > > with mast cells being activated. Has anyone else on this list acquired

> > > an allergy years after dx.?

> > > Thanks,

> > > Ellen

>

October 3, 2010

Also, I apologize for not introducing myself or being very active on this

site. I've been busy studying for the tech exam but I read all the emails!

I am from California and have a Bachelor's degree in Biology. I have been

volunteering at a private retail pharmacy since last October. I absolutely

love it, which is why I would like to become certified and have more hands

on experience.

I found out about this group after purchasing the Tech Lectures manual. I

just joined the group about a month or two ago. The group has been very

helpful and has many great resources that I have spent time looking at and

am very appreciative about. Thank you for putting in all this time for us to

work towards becoming certified.

Thanks again

Asmarah

On Sun, Oct 3, 2010 at 1:37 PM, Asmarah Amin <asmarah.a@...> wrote:

> Hi,

>

> I'm taking the national exam in 3 weeks. I've been studying with the Tech

> Lectures manual and Mosby's Pharmacy Technician Certification Exam book. Of

> both books, Mosby's is very detailed and comprehensive. I've been using the

> Tech Lectures to guide me on what areas I should focus on, but I'm still a

> bit nervous about whether I am completely prepared or not, since I didn't go

> through a pharm tech program. Sometimes it seems like any question about

> anything related to pharmacy can be on the exam and I won't be ready to

> answer it! But realistically, you can't memorize everything right?!

> I've looked at the study materials on the group and it's helped,

> thanks!

>

> But, Jeanetta and for those who have taken the exam, I am worried most

> about how much detail I should focus on memorizing medications, their trade,

> generic, and classifications.

>

> Any advice would be appreciated. Looking forward to the help!

>

> Thank you!

>

> Asmarah Amin

>

--

" ...for what else is there for us in this world except to make a good

intention to work hard and to struggle and to prepare for our meeting with

Allah (SWT)? "

-Imam Zaid Shakir

October 3, 2010

Dear Asmarah Amin,

Congratulations for taking the right step in acquiring TWO books plus using this

site to study for the PTCB exam! You just proved WHY you should have two

different exams study guides. The perspectives and emphasis are different among

the authors. I can tell you that Mr Medina of Techlectures has been in the past

of the opinion that you should not waste time studying for the Trade and

generics because he believes that there are 'relatively' few Trade/generic

questions on the exam to warrent it when you could be studying other things. Yet

he does have the Top 200 drugs listed in his book. I am not sure if his opinion

has changed in the last 2 years or not.

That being said I have always maintained my opinion that the test does ask

pharmacology questions as well, not just plain Trade/generic questions. So while

it is true that there are few questions that are straight forward Trade/generic

questions such as " which of the following is the generic name for XYZ? " there

are also test questions that encompass:

1. Classifications

2. Use and Indications (UAD's for specific disease states)

3. Storage and Handling (Safety Precautions)

4. Availability (Possible drug dosage forms and strengths)

5. Site of Action

6. Mechanism of Action

7. Site of Metabolism

8. Adverse Reactions (SE an TE)

9. Drug Interactions

10. Precautions

11. Contraindications

12. Allergies most common with specific drugs

13. Common Idiocycratic responses with specific drugs

14. Auxiliary labels that should be applied

15. Anything peculiuar to the drug (that which is not usual to other drugs)

16. Look-alike and Sound-alike drugs in an answer to confuse you

17. Packaging for the patient vs packaging from the manufacturer.

The above is what is known as pharmacology. It is in brief compared to what the

pharmacist must know. You have no clue which questions you will be asked about

which drugs on the exam - NO ONE KNOWS! (except for PTCB). And you have no clue

how much WEIGHT will be put upon each type of question. Some weigh more others

less, this is called 'scaled' weighted questions. So the minimum score of 650

points out of 900 points are scaled points, meaning that the questions do not

all count 1 point each. This by the way is a 72% of scaled points.

To answer ANYONE of the above types of questions you would have to have studied

the full pharmacology of the drug (yes that would mean each of the 200 drugs).

That means all of the drus you can since you don't know which ones will be on

the exam. That TRANSCENDS into you don't know which drugs you are going to fill

on a given day in the pharmacy. You can bet on a specific group of drugs, IF

you have experience as a tech, which ones you will fill because they are called

fast movers.

Given the fact that there are 90 questions which will count towards the exam, I

don't think that if there were only 1 type of the above question for 17

different drugs on the exam that you would want to ignore pharmacology, nor

ignore the Trade and generic list. PLEASE remember that the goal of taking the

PTCB exam is not merely the passing of it, but to PREPARE you to BE the BEST

Technician you can be, so that you do not end up taking the life of a little

baby girl or boy because you did not or do not know:

1. The tonicity of blood, and therefore the problem with using 23.4% NaCl vs

0.9% NaCl in an IV.

2. The difference between diphenhydramine and dimenhydrinate

3. The difference between 10 USP Units of Heparin, 100 USP Units of Heparin,

1000 USP Units of Heparin, 10,000 USP Units of Heparin

4. The difference between digoxin 0.125 mg and 125 mcg or digoxin 0.125 mg vs

0.25 mg

5. The significance of a prescription that reads Halcion 0.5 mg MRx1, what is

wrong with this order.

6. The significance of Calcium Chloride and Potassium Phosphate being placed one

after the other in an intravenous admixture.

The list is endless. So anyone out there reading, if you think you will learn

all of the above (and so much more) on the job 'in time' - " quick enough " to save

a life and prevent a medication error, please know that once you are hired or in

training on the job you will be too busy answering phones, retrieving drugs from

the shelf, shelving/stocking and unpacking drug orders, ordering drugs,

selecting, counting, pouring, mixing drugs, computer generating labels and

labeling prescription drug containers, entering Rx orders into the computer,

adjudicating/processing orders, calling paitients/doctors offices/nurses/various

departments, greeting varous people not just patients at the window, delivering

meds, dispensing meds to patients/nurses/floor stock, prepackaging unit dose or

prepackaging containers of commonly prescribed drugs, filling cassettes/robots,

making IVPB's/LVP's/TPN's, compounding various other dosage forms, billing and

insurance, patient advocacy, examining results for significant clinical lab

values (advanced tech duty) etc, etc etc This list, too is endless. And ALL the

TIME you are doing the above you don't have time to learn the pharmaology that

you should have known before you even stepped foot in the pharmacy in order NOT

to make any of the outlined mistakes! AND dont' forget you will still NEED to be

learning the pharmacology of NEW drugs that your pharmacy just got in on the

shelves because they are new on the market. And ALL the time using the

pharmacology that you should have known to prevent a medication error, report

one, find one before it is given to the patient (intervnetion of a near miss).

Formal education does give a bit of a jump on this or a head start. The program

taht I teach has over 800 drugs that the student must learn the pharmacology,

not merely the trade and generic. Even that however can not totally prepare the

tech/you for what is in store for them/you on the job. Oh yeah one more thing

you will be very busy...er too busy, learning the computer system and the

mneuonics in order to perform order entry and produce labels, to be learning

pharmacology on the job. Many find the job learning experience very overwhelming

and stressful. But those who do the best and find it the easiest or less

stressful are those are the most prepared and have learned the most before

entering a pharmacy.

I do not mean to scare you! There are way more drugs on the market now than

there was 10, 15 or 20 years ago. More delivery systems and drug dosage forms

exist, more tests that can aid diagnostics. I only wish to make a point.

Preparing for the PTCB should not be just to pass, but rather to perform as a

tech learning on the job at your optimum, and with as much knowledge as possible

to prevent an error or at least recognize that you do not know enough about what

you are supposed to know to fill an order and to STOP and ask a PHARMACIST.

Sounds easy! But you would be surprised how many " think that they know " what

they are supposed to or should know, and therefore do not ask.

In some defense of the technician who has been blamed for the medication error

that caused the death of little in the state of Ohio, she did say that she

felt that something was off, something was wrong with the order or how she

filled it. She did report it to the pharmacist. But she just did not know about

tonicity because she never studied for the PTCB exam or went to a formal school

program, not to mention her lack of time on the job/experience.

Litle from Ohio, about tougher Ohio laws

How cute she was!

http://www.usatoday.com/money/industries/health/2008-02-24-emily_N.htm

's Story

" Jerry died at the age of two as the result of a medication error caused

by a pharmacy technician. On the day that was to have her final chemo

treatment and received an excellent prognosis from physicians, she was given a

fatal dosage of chemotherapy. The pharmacy technician who prepared 's

chemotherapy had opted to compound her own normal saline base solution, as

opposed to using a commercially manufactured (prepacked) IV solution bag.

Standard IV bags contain a base solution of 0.9% NaCL (sodium chloride); the

base solution prepared for contained approximately 20x the standard

concentration of sodium chloride. Prior to entering a coma, grabbed her

head, screamed and cried as she experienced a fatal overdose of sodium chloride.

Although pharmacy technicians practice under the supervision of a licensed

pharmacist, the public assumes that these individuals are still required to be

properly trained and demonstrate competency to work within a pharmacy setting.

While controversy still remains over the specific circumstances of what occurred

that day in the pharmacy, the fact remains that a major medication error

occurred, went uncaught and ultimately cost Jerry her life. In the

aftermath, local and national media attention exposed the gross inadequacies of

pharmacy technician standards and regulations in Ohio (as well as across most of

the United States). "

Please re-read:

" Prior to entering a coma, grabbed her head, screamed and cried as she

experienced a fatal overdose of sodium chloride. "

Even if she/the Ohio technician had studied for the exam, if she had been the

type of person to say to herself " Oh I don't need to study that because there

will only be 17 questions out of 90 (19%) questions like that on the exam " , then

studying for the exam would be meaningless and the death of a patient (no matter

the age) would be PURE MEANINGLESS.

Okay if you have not figured it out yet, I do not agree with studyng just the

minimum! Go for it! The life you save may be your friend's,relative's or even

your own! What I mean by that is saving yourself from the agony of maming or

killing someone (a true life sentence) or paying a high fine or being sued for

all you have except for your house and car or paying the price with your

reputation and career (your home life will be destroyed)! And possibly from time

in prison, like the pharmacist who failed to get up off his rear end and check

out the IV and what the tech was talking about.

I pray that the technician got some counseling.

YES we can all make mistakes and we will! Studies have proven that that about

" 195,000 people die from preventable medical mistakes each year. " (HealthGrades)

BUT if WE, YOU or I can avoid them by our ACTIONS or shall I say if we can CAUSE

them by our ACTIONS, as well as INACTIONS, then we can only say we are the root

cause of the specific medication error. Choosing not to study, no to learn as

much as we can is an INACTION and it is deliberate!

" A total of 391 patients with 420 unit admissions were studied during 1490

patient-days. We found 120 adverse events in 79 patients (20.2%), including 66

(55%) nonpreventable and 54 (45%) preventable adverse events as well as 223

serious errors. The rates per 1000 patient-days for all adverse events,

preventable adverse events, and serious errors were 80.5, 36.2, and 149.7,

respectively.

Conclusions: Adverse events and serious errors involving critically ill

patients were common and often potentially life-threatening. Although many types

of errors were identified, failure to carry out intended treatment correctly was

the leading category. " The Critical Care Safety Study: The incidence and nature

of adverse events and serious medical errors in intensive care

*http://journals.lww.com/ccmjournal/Abstract/2005/08000/The_Critical_Care_Safety\

_Study__The_incidence_and.3.aspx

" In a study by the FDA that evaluated reports of fatal medication errors from

1993 to 1998, the most common error involving medications was related to

administration of an improper dose of medicine, accounting for 41% of fatal

medication errors. Giving the wrong drug and using the wrong route of

administration each accounted for 16% of the errors. Almost half of the fatal

medication errors occurred in people over the age of 60. Older people may be at

greatest risk for medication errors because they often take multiple

prescription medications. " The Most Common Medication Errors

http://www.medicinenet.com/script/main/art.asp?articlekey=55234

" To err is human " , but to err due to a purposeful decision NOT to prevent is

inhumane!

A decision NOT to study a specific topic that would prevent medication errors ,

such as pharmacology or simply the Trade and generic names of 200 drugs (when

there are over 4000 on the market), is inhumane.

That is my opinion only and these are MY WORDS. Except for the quoations with

references all of this post as are all of my posts copyrightes. This in

particular is Copyrighted by Jeanetta Mastron October 3, 2010

Thank you Asmarah for your question. I hope that you now see WHY you must study

all that you can NOW before you become a technician.

I have recommended the Techlectures study guide over the years because it has a

great simple way of teaching math. It highlights the main laws. The overall

approach is non-threatening to the student and in an easy to learn format. But I

also recommend a second book from a different author, as I know most other

books/study guides are in greater detail of other aspects of pharmacy which

prepare the student to become a pharmacy technician. And of course I recommend

asking questions and using the tutorials on this site for difficult to

understand topics and to have someone to ask questions when you just don't get

it. By the way I believe there is a site for Techlecture book owners to visit

to ask questions of the author: Joe Medina.

The book will have that site listed. Try http://www.techlectures.com/

To Err is Human 2000

http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20\

is%20Human%201999%20%20report%20brief.pdf

Five Years After " To Err Is Human " : What Have We Learned?2005

" The single most important step, however, is to set and adhere to " strict,

ambitious, quantitative, and well-tracked national goals, " say Leape and

Berwick. They urge AHRQ to bring together organizations, including JCAHO, CMS,

and the American Medical Association, to agree to a set of patient safety goals

to be reached by 2010. The most important lesson of the past five years, the

authors argue, is that " we will not become safe until we choose to become safe. "

"

http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2005/May/\

Five-Years-After--To-Err-Is-Human---What-Have-We-Learned.aspx

http://jama.ama-assn.org/cgi/content/short/293/19/2384

Asmarah and ALL, I hope you will CHOOSE to become safe by choosing to embrace

learning of as much as you can before you step foot in a pharmacy. But remember

learning should never STOP!

Respectfully,

Jeanetta Mastron CPhT BS

Pharmacy Technician Educator

Founder/Owner of this site

Hi,

I'm taking the national exam in 3 weeks. I've been studying with the Tech

Lectures manual and Mosby's Pharmacy Technician Certification Exam book. Of

both books, Mosby's is very detailed and comprehensive. I've been using the Tech

Lectures to guide me on what areas I should focus on, but I'm still a bit

nervous about whether I am completely prepared or not, since I didn't go

through a pharm tech program. Sometimes it seems like any question about

anything related to pharmacy can be on the exam and I won't be ready to

answer it! But realistically, you can't memorize everything right?!

I've looked at the study materials on the group and it's helped,

thanks!

But, Jeanetta and for those who have taken the exam, I am worried most about

how much detail I should focus on memorizing medications, their trade, generic,

and classifications.

Any advice would be appreciated. Looking forward to the help!

Thank you!

Asmarah Amin

October 3, 2010

Dear Asmarah Amin,

No apology necessary!

Where in CA are you? I am in CA as well,not far from Disneyland.

Glad you have two good books to work from and using this site.

Please feel free to ask more questions, not all of my answers to questions are

as lengthy as the last one!

Respectfully,

Jeanetta Mastron CPhT BS

Founder/Owner

>

> > Hi,

> >

> > I'm taking the national exam in 3 weeks. I've been studying with the Tech

> > Lectures manual and Mosby's Pharmacy Technician Certification Exam book. Of

> > both books, Mosby's is very detailed and comprehensive. I've been using the

> > Tech Lectures to guide me on what areas I should focus on, but I'm still a

> > bit nervous about whether I am completely prepared or not, since I didn't go

> > through a pharm tech program. Sometimes it seems like any question about

> > anything related to pharmacy can be on the exam and I won't be ready to

> > answer it! But realistically, you can't memorize everything right?!

> > I've looked at the study materials on the group and it's helped,

> > thanks!

> >

> > But, Jeanetta and for those who have taken the exam, I am worried most

> > about how much detail I should focus on memorizing medications, their trade,

> > generic, and classifications.

> >

> > Any advice would be appreciated. Looking forward to the help!

> >

> > Thank you!

> >

> > Asmarah Amin

> >

>

> --

> " ...for what else is there for us in this world except to make a good

> intention to work hard and to struggle and to prepare for our meeting with

> Allah (SWT)? "

> -Imam Zaid Shakir

>

October 4, 2010

I, too, am studying for the exam using Mosby's Review book and the interactive

CD. It's quite a learning experience, I must say. I will never memorize

everything; no one does; but I think the trick is to practice it. Challenge

yourself and make up questions. I've found some errors (I think) on the disc

that made me think about the answer. I guess that's part of the learning

process.

Good luck.

October 5, 2010

Since humans write books, CD's and Flash learning online, errors are inherrent

to the process. Just as making an error on the job. But writers have editors and

editors do try to find the problems before hand and they too are human. Likewise

pharmacists try to find the error that a tech does not find or makes. But

sometimes they can not. But we try and we put in systems to avoid those errors.

Studying to pass the PTCB exam is a system we put in place to prevent as many

errors on the job as possible. I am glad that you are making good use of your

time with good resources and finding ways to learn. That is half the battle.

In my classroom students write summaries after lecture and also develop q and a

to help study. Making tests empowers the learner, and the student begins to

outsmart the test or the teacher who made the test! One learns to expect or

HOW to expect what will be on the exam. Likewise asking your self questions NOT

in the book or anticipating what should be asked is one way to study and to

learn!

Bravo !

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

F/O

From: <yoh765@...>

Subject: Re: question

Date: Monday, October 4, 2010, 2:42 PM

I, too, am studying for the exam using Mosby's Review book and the interactive

CD. It's quite a learning experience, I must say. I will never memorize

everything; no one does; but I think the trick is to practice it. Challenge

yourself and make up questions. I've found some errors (I think) on the disc

that made me think about the answer. I guess that's part of the learning

process.

Good luck.

October 6, 2010

I have a quick question maybe two. First, has anyone in the history of this

group ever passed the ExCPT exam? I am a state licensed Pharmacy Technician, and

I have been a member of this group for a while. I am currently studying for the

PTCB test, but I found that having it and not having it can work against you on

both ends-let me explain. I went to a interview for at a chain pharmacy for a

full-time Pharmacy Technician position. I don't have my national certification,

but have all the other crudentials. The first interview was just the basic one.

They called me back for a second interview, and this interview was conducted by

the Pharmacist. I thought everything went well. A week went by, and I didn't

hear anything from them. I called the store back and talked to the store

manager, and she advised me that she wanted to offer the position to me, but the

pharmacist said no. Long story-long, the manager told me in the first interview,

that they had a training program where after you complete it, they will pay for

you to take your national certification test. After talking to the manager

again, the pharmacist didn't want to hire me because I didn't have my national

certification. The other question I wanted to know if the PTCB test is better to

have or the ExCPT. The reason I ask is that within the last few days I found out

the ExCPT is accepted in the state I live in.

________________________________

From: Jeanetta Mastron <rxjm2002@...>

Sent: Tue, October 5, 2010 6:26:20 AM

Subject: Re: Re: question