Position yourself in front of a highly targeted audience of Certified Pharmacy Technicians and pharmacy technician students through CPhT CONNECT™ - the magazine for pharmacy technicians. With a fresh, contemporary style, CPhT CONNECT™ skillfully combines critical pharmacy-related news with practical articles, insightful commentaries and valuable continuing education programs.
table of Contents departments volume 5 issue 2
STAFF Publisher & Editor-in-Chief Mike Johnston, CPhT-Adv, BCSCPT, BCNCPT, BCHCPT
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disease brief: Measles disease brief: Bronchitis disease brief: Hyperthyroidism member spotlight: Daniel Kyes,CPhT,CSPT,BCSCPT
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Publisher’s Note News Briefs product news community rx health-system rx
Executive Assistant Cess Literatus
Creative Director Peter Ian Fazon
Director of Education Josh Cano, CPhT-Adv, BCSCPT, BCNCPT, BCHCPT Manager, Continuing Education Ashleigh Smith, CPhT
CE: The NIOSH Hazardous Drug List 30 Discover how hazardous drugs are defined, classified, and managed within healthcare environ- ments to ensure the safety of healthcare workers. This article delves into the creation and development of the NIOSH Hazardous Drug List, highlighting the various key regulatory organizations involved and the stringent criteria used to identify these drugs. It also explores the historical context, the harmful ef- fects of drug exposure, and the progression of classification systems that have been put in place to bet- ter protect workers from the potential risks posed by hazardous substances. Written by Jim, Mizner, RPH. ACPE UAN: 0384-0000-25-031-H03-P, 0384-0000-25-031-H03-T 2.0 Contact Hours Workforce Report 22 Dive deep into the 2025 national report, where pharmacy technicians share their insights on crucial issues such as wage trends, burnout, and the evolving challenges they face in the workplace. This comprehensive analysis provides a detailed, data-driven look at the current state of the pharmacy technician workforce, shedding light on the factors contributing to job dissatisfaction and offering a glimpse into what may lie ahead for the profession, as well as potential strategies for improvement.Written by Mike Johnston, CPhT-Adv. The 2025 Pharmacy Technician Beyond Interpersonal Conflict 17 From shaky hands during a final check to systemic clashes between entire organizations, conflict in the pharmacy goes far beyond daily disagreements. This in-depth article explores the four types of con- flict pharmacy technicians face—intrapersonal, interpersonal, intergroup, and interorganization- al—and the impact each has on your body, your work, and your wellbeing. You'll learn proven strat- egies for managing your emotional responses and how to step into action when the pressure won’t let up. Whether you're new to the field or a seasoned tech, this guide equips you with the tools to face conflict head-on—with clarity, confidence, and purpose. Written by Amanda Abernathy, CPhT, MBA.
Member Services Jessica Sanders
Creative Team Amber Taylor, Events & Marketing Lead Mariana Ruiz, Digital Media Lead Precious Fazon, Socials & Comms Lead CONTRIBUTORS Amanda Abernathy, CPhT, MBA Jim Mizner, RPh Mike Johnston , CPhT-Adv , BCSCPT, BCNCPT, BCHCPT Tonique Hendrix, I.V. CPhT and the Editorial Advisory Board
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Opinions expressed in this publication do not necessar- ily reflect the official views of NPTA. The information contained in this magazine is for informational purposes only and does not constitute legal advice. No part of this publication is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something covered in this publication. The appearance of advertising or new product information does not constitute an endorsement by NPTA of the product(s) featured. © 2025 All rights reserved. No part of this publication may be reproduced without written consent from the publisher.
Luxury in Scrubs: My Life as A Traveling Pharmacy Technician 52
From five-star hotels to frontline disaster zones, this pharmacy technician has seen it all. With a suit- case full of scrubs and certifications, she’s built a high-level career on the road—compounding IVs one day, responding to hurricanes the next. Learn how she turned travel assignments into a thriv- ing lifestyle filled with purpose, flexibility, and adventure. For anyone considering the travel tech path, her story is both a roadmap and a dose of inspiration. Written by Tonique Hendrix, I.V. CPhT
CPhT CONNECT www.cphtconnect.com
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PUBLISHER’S NOTE
mike@pharmacytechnician.org
This
issue’s cover story, The 2025 Pharmacy Technician Workforce Report, is more than a feature article—it’s a wake-up call. It’s the most comprehensive snapshot of our profession to date, shaped by the voices of over 1,000 pharmacy technicians from across the country. And the message is clear: while pharmacy technicians are doing more than ever before, too many are still underpaid, under-recognized, and overstretched. But this report doesn’t just highlight problems…it points to solutions. From wage equity to credentialing, staffing models to benefits that actually matter, the data reveals what drives satisfaction, career growth, and long-term retention. For those of us who’ve spent years advocating for technician advancement, this survey isn’t surprising…but it is sobering. It confirms what many of us have been saying for years and what too many employers have yet to hear. That’s why I’m inviting our members to join me on May 27, 2025 for a live, exclusive webinar: The 2025 State of the Pharmacy Technician Career. We’ll go deeper into the survey’s findings, explore the trends shaping our future, and—most importantly—discuss how you can use this data to shape your own path forward. Whether you're new to the profession or decades in, this session will give you clarity, strategies, and a renewed sense of purpose. Our profession is at an inflection point. The stories and data in this issue prove that pharmacy technicians are not just essential—they’re ready to lead. I hope you’ll read this cover story and then join me as we look ahead together.
Mike Johnston, CPhT-Adv, BCNCPT, BCSCPT Founder & CEO, NPTA
Cheers,
Mike Johnston, CPhT-Adv, BCNCPT, BCSCPT, BCHCPT Founder & CEO, NPTA
Nunquam non paratus. Never unprepared.
CPhT CONNECT www.cphtconnect.com
5
DEPARTMENTS | NEWS BRIEFS
WHITE HOUSE ORDERS GLOBAL PRICING BENCHMARK FOR U.S. PRESCRIPTION DRUGS
administration estimates that this inter- national reference pricing model could reduce costs for certain drugs by up to 80%. The executive order also includes pro- visions targeting rebate structures and limiting the influence of pharmacy ben- efit managers (PBMs), signaling a major disruption to current pharmaceutical pricing frameworks. While the order is advocacy groups and bipartisan law- makers have introduced several reform bills, none have advanced far enough to offer real relief. The closures are espe - cially concentrated in rural and under- served areas, leaving patients without nearby access to critical medications and healthcare services. For pharmacy technicians in these settings, job secu- rity and continuity of care are now in jeopardy. This growing crisis under- scores the urgent need for legislative action and unified advocacy across the pharmacy profession.
expected to face legal and industry push- back, it marks a turning point in the national conversation on drug afford - ability. For pharmacy technicians, this could lead to major changes in inven- tory management, patient affordability assistance, and formulary adjustments. The ripple effects will likely be felt across both retail and health-system pharmacy operations.
INDEPENDENT PHARMACIES CLOSING AT ALARMING RATE AMID PBM REFORM GRIDLOCK More than 300 independent pharma- cies have shuttered their doors since late 2024, with industry experts point- ing to Congress’s failure to enact com- prehensive PBM reform as the primary driver. The current reimbursement model—largely dictated by PBMs—con- tinues to strain small pharmacies, with many unable to maintain profitability under below-cost payment structures and delayed reimbursements. While In a bold move aimed at lowering med- ication costs, President Donald Trump signed an executive order on May 12, 2025, mandating that U.S. prescription drug prices be tied to the lowest prices paid by other developed countries. The
FARMACIAS SIMILARES BRINGS “DR. SIMI” AND AFFORDABLE PHARMACY MODEL TO TEXAS
Similares has found massive success in Mexico by making medications more accessible to underserved communities. Its U.S. expansion could shake up the pharmacy landscape, especially in areas where independent and community pharmacies are struggling to compete on price. The move signals a growing demand for culturally competent, afford - able pharmacy services. Pharmacy tech- nicians may find emerging job oppor- tunities in these new locations or face increased competition depending on geographic overlap.
Farmacias Similares—the iconic Mexican pharmacy chain known for its low-cost medications and dancing “Dr. Simi” mascot—has officially established its U.S. headquarters in Austin, Texas. The com- pany is entering the American market with plans to offer over-the-counter drugs, health supplements, and eventu- ally, prescription services in cities with large Latino populations. Known for its no-frills, discount model, Farmacias
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PRODUCT NEWS | DEPARTMENTS
ATZUMI NASAL POWDER APPROVED FOR ACUTE MIGRAINE RELIEF
PENPULIMAB APPROVED FOR RARE HEAD AND NECK CANCER
The FDA has approved Atzumi , a novel nasal powder formulation of dihydroer- gotamine mesylate, for the acute treat- ment of migraine in adults. This new option offers a needle-free, fast-act - ing alternative for patients who need rapid symptom relief—especially those who experience nausea and cannot toler- ate oral medications. Its ease of admin- istration and portability may improve adherence for patients prone to sudden migraine attacks.
The FDA has greenlit penpu- limab-kcqx, a PD-1 blocking mono- clonal antibody, for the treatment of advanced nasopharyngeal carci- noma , a rare form of head and neck cancer. As a checkpoint inhibitor, penpu- limab adds another tool to the growing arsenal of precision immunotherapies. Its approval provides hope for patients who often have limited treatment options and face poor prognoses.
JOBEVNE BECOMES LATEST BEVACIZUMAB BIOSIMILAR FOR CANCER THERAPY
Jobevne (bevacizumab-nwgd) has been approved by the FDA as a biosimilar to Avastin, indicated for a variety of cancers including col- orectal, non-small cell lung, and glio- blastoma. With the rising demand for oncology cost-containment strategies, Jobevne offers a more affordable alternative without compromising clinical efficacy. Pharmacy teams in both hospital and specialty settings will likely see it added to formularies soon. method is designed for patients who struggle with traditional tablets or need discreet, convenient dosing. The film dissolves quickly without water, expanding treatment options in both inpatient and outpatient mental health settings.
VANRAFIA APPROVED FOR IGA NEPHROPATHY WITH HIGH RISK OF PROGRESSION Vanrafia (atrasentan) received FDA approval in April 2025 for reducing pro- teinuria in adults with primary immu- noglobulin A nephropathy (IgAN) who are at risk for rapid disease progres- sion. As a selective endothelin receptor antagonist, Vanrafia targets a key path- way involved in kidney inflammation and fibrosis. This approval marks an important step forward in managing a condition that frequently leads to end- stage renal disease.
MEZOFY ORAL FILM OFFERS NEW OPTION FOR SCHIZOPHRENIA PATIENTS In April 2025, the FDA approved Mezofy , an oral film formulation of aripiprazole, for the treatment of schizo- phrenia in adults and adolescents aged 13 and older. This new delivery
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DEPARTMENTS | COMMUNITY-RX
from opioid-related lawsuits as con- tributing factors to the collapse. This move not only affects thou - sands of pharmacy employees but also underscores the volatile state of the retail pharmacy industry—espe- cially for national chains struggling to adapt to post-pandemic consumer trends and reimbursement chal- lenges. For pharmacy technicians and support staff, it raises serious questions about job security and the need for strategic career planning. Independent pharmacies may see an influx of patients as Rite Aid locations close, but also face pres- sure to scale and meet demand. While some see this as a cautionary tale, others believe it marks a turn- ing point in the decentralization of pharmacy care. technicians, the case is a reminder of the critical role they play in safe- guarding patient health and ensur- ing proper documentation and red flag reporting procedures are fol- lowed. This high-profile legal action is expected to have a ripple effect across the industry, especially in how pharmacy chains manage con- trolled substances and regulatory training. Expect intensified scrutiny and audits across both chain and independent sectors.
ARKANSAS BANS PBMS FROM OWNING PHARMACIES IN BOLD MOVE FOR INDEPENDENCE In a landmark legislative move, Arkansas has officially banned phar - macy benefit managers (PBMs) from owning or operating pharmacies within the state. The new law, signed in April, aims to eliminate the conflicts of inter- est that arise when PBMs—middlemen that negotiate drug prices—also control pharmacy operations and reimburse- ments. This decision is a direct response to years of advocacy by independent pharmacists who say PBM ownership distorts the marketplace, often to the detriment of small businesses. Major PBMs like CVS Health have warned that the law could force them to close dozens of retail locations, but Arkansas lawmakers insist the measure is about protecting patients’ access to commu- nity-based care. Pharmacy technicians working in independent settings may experience a renewed sense of job secu- rity as policy shifts in their favor. The ruling is being closely watched by other states considering similar reforms, and could serve as a blueprint for broader PBM regulation nationwide. Ultimately, this could level the playing field for inde- pendent pharmacies battling systemic reimbursement disadvantages. and less operational chaos caused by con- stant financial uncertainty. Advocates see this as a long-overdue correction to a system that has disproportionately benefited large PBMs at the expense of community pharmacies. If successful, Alabama’s approach may inspire similar efforts in other states.
RITE AID FILES FOR SECOND BANKRUPTCY—WILL EXIT RETAIL PHARMACY MARKET In a dramatic shakeup of the retail phar- macy landscape, Rite Aid has filed for Chapter 11 bankruptcy for the second time, signaling the company's intent to exit the retail pharmacy business entirely. With more than 1,200 stores still in operation across the U.S., Rite Aid is now pursuing plans to sell or shut- ter all remaining locations in the coming months. Industry analysts cite years of financial losses, high debt, and fallout
WALGREENS TO PAY $350 MILLION IN OPIOID SETTLEMENT WITH DOJ
ALABAMA PASSES PBM REIMBURSEMENT LAW TO PROTECT INDEPENDENT PHARMACIES Walgreens has agreed to a $350 million settlement with the U.S. Department of Justice following accusations that the company filled hundreds of thousands of unlawful opioid prescriptions. The set- tlement addresses claims that Walgreens failed to uphold proper oversight and dispensing protocols between 2006 and 2019, contributing to the nation’s opioid crisis. As one of the largest pharmacy chains in the country, this agreement sends a strong message about corpo- rate accountability and the importance of strict regulatory compliance. While Walgreens has not admitted wrongdo- ing, it has committed to strengthen- ing its internal controls and training practices going forward. For pharmacy Alabama has taken a bold stand in the fight for fair reimbursement, passing leg- islation that requires pharmacy benefit managers (PBMs) to reimburse indepen- dent pharmacies at rates no lower than those paid by Medicaid. This change is a major win for small and rural phar- macies that have struggled to remain
solvent amid declining PBM payments and arbitrary reimbursement clawbacks. By mandating minimum reimbursement thresholds, lawmakers hope to preserve local access to pharmacy care—especially in underserved areas where independent pharmacies are often the only providers. The law could also reduce pharmacy closures and layoffs, which have plagued the state in recent years. For pharmacy technicians, this legislative victory may translate into more stable employment
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HEALTH-SYSTEM RX | DEPARTMENTS
to deliver high-quality care while facing shrinking margins—and this reduction in spending may signal a shift toward more value-based care models. For health-sys- tem pharmacy teams, this presents both a challenge and an opportunity: inno- vating clinical services while managing increasingly complex cost dynamics. Pharmacy leaders are now tasked with maintaining patient outcomes while identifying smarter, more sustainable ways to manage budgets.
HOSPITAL DRUG SPENDING DECLINES
In a surprising turn, hospital phar- macy drug spending decreased by 1.1% in 2023, even as national prescription drug expenditures jumped by 13.5%. This data, published by the American Society of Health-System Pharmacists (ASHP), highlights how health systems are bucking national trends through aggressive cost containment, drug utili- zation controls, and increased outpatient transitions. Hospitals are under pressure
2025 ASHP FORECAST
need for collaboration with finance and IT departments to manage drug utiliza- tion and emerging therapies effectively. Pharmacy technicians in hospital set- tings may soon see more integrated roles that combine clinical support with data and tech fluency. The takeaway? The health-system pharmacy model is evolving—and teams that embrace inno- vation will be better equipped for the challenges ahead.
MANAGED CARE PHARMACY SET TO RESHAPE HOSPITAL PRACTICES The AMCP Foundation, in collabo- ration with Pfizer, has published a for- ward-looking report on major trends influencing managed care pharmacy— and many are directly relevant to health-system pharmacy teams. From the rapid evolution of personalized medicine to shifting value-based reimbursement models, hospital pharmacies are being pulled into more complex financial and The 2025 ASHP Pharmacy Forecast highlights a seismic shift in hospital phar- macy practice, driven by three key forces: the rise of artificial intelligence, the influx of ultra-high-cost specialty drugs, and worsening workforce shortages. The report urges pharmacy leaders to lean into predictive analytics, automation, and cross-training to alleviate staffing burdens. It also emphasizes the growing to reimagine staffing models, bolster automation, and standardize regulatory procedures to stay efficient and compli - ant. The report also notes that pharmacy technicians may need to develop more specialized competencies as the scope of their roles expands. Health systems that respond proactively—especially in train- ing, resource planning, and workflow design—are expected to maintain a com- petitive edge in clinical performance and cost control.
FOUR PRESSING ISSUES FACING HOSPITAL PHARMACY IN 2025
CompleteRx recently released a timely update on the top operational chal- lenges facing hospital pharmacies in 2025. These include a critical shortage of qualified personnel, ongoing supply chain instability, increasingly complex compliance demands, and the pressure to adopt and integrate new technologies. Pharmacy departments are being forced
clinical ecosystems. The report empha- sizes the need for strong data infrastruc- ture, tech-enabled workflows, and inter- departmental coordination to support these trends. Pharmacy technicians may find themselves increasingly involved in formulary support, patient access naviga- tion, and data analytics. As care delivery continues to migrate toward precision and accountability, hospital pharmacy departments will play an even more stra- tegic role in optimizing both outcomes and costs.
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MEASLES | DISEASE BRIEFS
Once considered eliminated in the United States, measles has seen a resurgence in recent years due to declining vaccination rates and increased global travel. Caused by the measles virus, this highly contagious infection spreads through airborne respiratory droplets and can linger in the environment for up to two hours after an infected person has left the area. The virus is especially dangerous for young children, pregnant individuals, and immunocompromised patients, often leading to serious complications such as pneumonia, encephalitis, and long-term neurologic damage. Although vaccination remains the most effective preventive measure, pharmacy technicians play a crucial role during outbreaks—ensuring accurate medica- tion handling, supporting timely immunizations, and helping patients navigate access to treatments. MEASLES DISEASE STATE BRIEF
SYMPTOMS OF MEASLES
DIAGNOSIS AND TRANSMISSION
Diagnosis is based on clinical presentation and confirmed through laboratory testing such as IgM serology or PCR testing. Because of the virus’s extreme contagiousness—affecting up to 90% of susceptible individuals exposed—public health authorities require measles cases to be reported immediately to help contain the spread. Pharmacy technicians may first encounter potential cases through prescrip- tion or vaccine activity during outbreaks. It is essential to recognize time-sen- sitive needs, especially for post-exposure prophylaxis (PEP), and escalate them to the pharmacist quickly.
Measles typically begins 7 to 14 days after exposure and progresses in stages. Patients are contagious from four days before the rash appears until four days after. Common symptoms include: • High fever (often >104°F) • Cough • Coryza (runny nose) • Conjunctivitis (red, watery eyes) • Koplik spots (tiny white spots inside the cheeks) • Maculopapular rash starting on the face and spreading downward • Fatigue, malaise, and loss of appetite Complications are more likely in high-risk populations and can include ear infec- tions, diarrhea, pneumonia, and in severe cases, brain swelling (encephalitis).
PRESCRIPTION TREATMENT OPTIONS
No antiviral medication is specifically approved to treat measles. Instead, pre- scription therapies focus on symptom management and the prevention of complications. Common prescription options include: • Vitamin A (Retinol) • Recommended for children to reduce severity and complications • Typical dosing: 200,000 IU once daily for two days (adjusted for age) • Antibiotics • Used only for secondary bacterial infections such as pneumonia or otitis media • Examples: amoxicillin, azithromycin • Post-Exposure Prophylaxis (PEP) • MMR vaccine within 72 hours of exposure may prevent or lessen illness • Immune globulin (IG) within 6 days is used for high-risk individuals who cannot receive live vaccines (e.g., infants, pregnant individuals) Pharmacy technicians should double-check dosing, particularly for pediat- ric patients, and flag any urgent PEP prescriptions for immediate pharma- cist review.
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DISEASE BRIEFS | MEASLES
OVER-THE-COUNTER (OTC) TREATMENT SUPPORT
Though there are no OTC cures for measles, symptomatic relief can improve patient comfort and reduce complications from fever or dehydration. Products such as acetaminophen or ibuprofen may be used to reduce fever and pain, while saline sprays or mild antihistamines can help relieve congestion. Hydration support through oral electrolyte solutions may be beneficial in patients with gastrointestinal symptoms. When assisting with OTC selection, pharmacy tech- nicians should always consider age-appropriate options and direct questions to the pharmacist when in doubt.
SPECIAL STORAGE REQUIREMENTS
Products used for measles prevention and management require careful atten- tion to storage and handling. The MMR vaccine must be refrigerated between 2–8°C (36–46°F) and should not be frozen. Once reconstituted, it must be used within eight hours. Immune globulin products also require refrigeration and protection from light. Vitamin A supplements, in contrast, are stored at room temperature, away from heat and direct sunlight. To ensure product safety, technicians involved in inventory should routinely check expiration dates, monitor temperature logs, and report any storage discrepancies immediately.
INSURANCE ISSUES AND TIPS FOR RESOLUTION
Insurance limitations can hinder access to measles-related care, especially during outbreaks. While MMR vaccines are typically covered under preven- tive care mandates, uninsured patients may benefit from state programs like Vaccines for Children (VFC). Technicians should be aware of local resources to help patients find affordable vaccine access. Immune globulin is often expensive and may require prior authorization. Pharmacy technicians can help expedite this process by gathering necessary documentation, such as exposure history and patient risk factors. Depending on diagnosis codes, vitamin A may or may not be covered; OTC versions may be a viable alternative, pending pharmacist recommendation.
COUNSELING POINTS & PHARMACIST ALERTS Although pharmacy technicians cannot offer direct counseling, we are often the first to identify situations that need pharmacist intervention. Be on the lookout for: • Patients requesting PEP following known exposure • High-dose vitamin A prescriptions for children (verify age and dosing) • Questions about vaccine timing or interactions with other live vaccines • Immunocompromised or pregnant patients who may be unable to receive MMR By flagging these encounters quickly, technicians help ensure that patients receive the safest, most appropriate care possible.
WORKFLOW TIPS FOR TECHNICIANS
Outbreak periods can strain pharmacy resources and increase urgency in med- ication processing. Technicians can support workflow efficiency by verifying vaccine eligibility and documentation, reviewing immunization history in the pharmacy system, and ensuring proper handling of refrigerated items like the MMR vaccine and IG. During high-volume periods, time-sensitive prescrip- tions—especially those tied to exposure windows—should be prioritized and immediately brought to the pharmacist’s attention. Additionally, assisting with prior authorizations, copay program information, and resource referrals can dramatically reduce barriers for patients in need of care. CONCLUSION Measles may be preventable, but it remains a serious public health threat when it reemerges. For pharmacy technicians, each outbreak is a call to action: to manage vaccine inventory with precision, support rapid response treatment, and recognize patient needs before complications arise. Your attention to detail and dedication to safety are key to reducing the impact of this disease and helping to keep your community protected.
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BRONCHITIS | DISEASE BRIEFS
Bronchitis is one of the most frequently encountered respiratory conditions in the phar- macy setting. It occurs when the bronchial tubes—the airways that connect the windpipe to the lungs—become inflamed and irritated. This inflammation leads to increased mucus production, narrowed airways, and the signature symptom: a persistent cough. There are two primary types of bronchitis: acute and chronic. Acute bronchitis is usually triggered by a viral infection and often develops after a cold or the flu. It typically resolves within two to three weeks but can leave behind lingering fatigue and coughing spells. Chronic bronchitis, by contrast, is a long-term condition that falls under the umbrella of Chronic Obstructive Pulmonary Disease (COPD). It’s defined by a productive cough that lasts for at least three months each year for two consecutive years and is most often caused by smoking or long-term exposure to environmental irritants. Regardless of the type, pharmacy technicians are key players in helping patients manage symptoms, navigate insurance barriers, and ensure the safe, effective use of medications and devices BRONCHITIS DISEASE STATE BRIEF
SYMPTOMS OF BRONCHITIS Symptoms can vary depending on the type and severity of bronchitis, but the core complaints tend to be consistent: • Persistent cough (with or without mucus) • Chest tightness or discomfort • Shortness of breath or wheezing • Mild fever or chills (more common with acute bronchitis) • Fatigue or feeling run-down • Increased mucus production, particularly in the mornings (common in chronic bronchitis) If a patient’s symptoms last longer than three weeks, worsen over time or include blood in the sputum, it’s important that they follow up with a healthcare provider. Pharmacy technicians should refer these concerns to the pharmacist promptly.
PRESCRIPTION TREATMENTS
The treatment of bronchitis depends on whether the condition is acute or chronic, as well as on the patient’s medical history and risk factors. For acute bronchitis, medications are usually aimed at relieving symptoms rather than curing the infection: • Antibiotics , such as azithromycin or amoxicillin-clavulanate, may be prescribed only when a bacterial infection is suspected or if the patient is at higher risk for complications. • Short-acting bronchodilators , like albuterol inhalers, are used to open airways and reduce wheezing or chest tightness. • Systemic corticosteroids , including prednisone or methylprednis- olone, may be prescribed in more severe or persistent cases to reduce airway inflammation. For chronic bronchitis, treatment typically involves maintenance medica- tions that reduce symptoms, prevent flare-ups, and improve lung function: • Long-acting bronchodilators , such as tiotropium (Spiriva) and salmeterol (Serevent), help keep airways open throughout the day. • Inhaled corticosteroids , like fluticasone or budesonide, are often used in combination with bronchodilators in products such as Advair or Symbicort. • Nebulized medications , including albuterol and ipratropium, may be prescribed for patients who struggle with inhaler technique or require more intensive therapy. • Systemic corticosteroids are occasionally used during exacerba- tions to reduce severe inflammation. • Mucolytics , like acetylcysteine, may be added to help thin mucus and improve clearance. Pharmacy technicians should confirm the delivery method (inhaler vs. nebu- lizer), check that any required devices (spacers, masks) are provided, and verify dosing instructions match the prescribed product.
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DISEASE BRIEFS | BRONCHITIS
COUNSELING POINTS TO RELAY/ALERT THE PHARMACIST
OVER-THE-COUNTER (OTC) TREATMENT SUPPORT
PRACTICAL WORKFLOW TIPS FOR TECHNICIANS Bronchitis care often includes multiple delivery devices, special storage instruc- tions, and insurance complexities. Ensuring a smooth workflow starts with accu- rate data entry and careful product selection. Technicians should confirm the correct formulation was dispensed—especially if switching between an inhaler and a nebulized version—and verify whether accessories like spacers or masks were ordered. Although pharmacy technicians do not counsel patients directly, they are often in the best position to recognize when a pharmacist’s guidance is needed. If a patient is picking up an inhaler for the first time, appears unsure how to use it, or is struggling with cost or adherence, those are all signs to involve the phar- macist. Technicians should also flag patients who are refilling albuterol more than twice a month—this could indicate poorly controlled symptoms. Other red flags include a cough lasting more than three weeks, blood in sputum, or worsening shortness of breath. In these cases, technician awareness can make the difference in getting patients timely support and appropriate care. Medications with refrigeration requirements should be stored and labeled cor- rectly, and any questions about unusual directions should be clarified before the prescription is completed. Frequent refills on prednisone or albuterol can be a sign of uncontrolled disease and should be flagged to the pharmacist for possible follow-up with the prescriber. CONCLUSION Whether it appears as a seasonal cough or a chronic condition that follows a patient through life, bronchitis is a disease state pharmacy technicians encounter regularly. Understanding the difference between acute and chronic forms, being familiar with treatment options and delivery devices, and identifying red flags during the pharmacy workflow all contribute to better patient outcomes. With attention to detail and a collaborative mindset, pharmacy technicians are vital partners in the respiratory care process—ensuring every patient has access to safe, effective treatment and the support they need to breathe easier.
OTC medications are often the first line of defense for patients dealing with mild or early symptoms of acute bronchitis. These treatments don’t cure the condi- tion but can provide meaningful relief. Cough suppressants containing dextro- methorphan are commonly used to ease dry, irritating coughs, while guaifenesin helps thin and loosen mucus in productive coughs.For pain, chest discomfort, or low-grade fever, acetaminophen or ibuprofen may be recommended. Pharmacy technicians should always verify there are no contraindications and refer any questions about OTC product selection to the pharmacist.
SPECIAL STORAGE REQUIREMENTS
Storage instructions can vary based on the type of medication being dispensed, making technician attention to detail crucial. Most inhalers should be stored at room temperature and protected from heat or freezing temperatures. Freezing can damage the mechanism inside metered-dose inhalers and make them unus- able. Nebulizer medications, such as DuoNeb, may come in unit-dose vials that require refrigeration, depending on the formulation. Always check the packag- ing for specific storage guidelines. In the case of liquid antibiotics, like amoxi- cillin-clavulanate, proper refrigeration is required after reconstitution, and the medication must be discarded after 10 days. Labeling refrigerated products clearly and offering reminders at pickup can prevent misuse and ensure the medication works as intended.
COMMON INSURANCE ISSUES AND TIPS FOR RESOLUTION
Bronchitis treatment—particularly for chronic management—often runs into insurance challenges. Inhalers, combination products, and nebulized medica- tions are frequent targets for prior authorization. Plans may also implement step therapy, requiring patients to try lower-cost alternatives like albuterol before approving long-acting therapies. Formulary restrictions are another common issue. In some cases, the prescribed brand may not be covered, even when no therapeutic equivalent is available without extra paperwork. Pharmacy tech- nicians can help expedite resolution by checking insurance coverage early in the filling process, flagging high-cost items, and recommending pharmacist consultation if alternatives or appeals are needed. Copay assistance cards from manufacturers can also be valuable tools to help patients afford brand-name therapies.
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HYPERTHYROIDISM | DISEASE BRIEFS
HYPERTHYROIDISM DISEASE STATE BRIEF
In a busy pharmacy, it’s not uncommon to see a patient who appears healthy on the surface but quietly mentions fatigue, jitteriness, or a racing heart. At first glance, it might sound like anxiety or maybe too much caffeine. But for many, these symptoms stem from something far more systemic: hyperthyroidism. This condition occurs when the thyroid gland becomes overactive, producing excessive amounts of thyroid hormones—specifically thyroxine (T4) and triiodothy- ronine (T3). These hormones control how the body uses energy, and when present in excess, they speed up nearly every metabolic process. For patients, that means everything from heart palpitations and insomnia to unexplained weight loss and emotional instability. Pharmacy technicians are in a unique position to support hyperthyroid patients, especially since their journey often involves multiple medications, lab work, and the need for close monitoring. Understanding this condition not only improves technician workflow—it can also play a critical role in patient safety and care quality.
SYMPTOMS OF HYPERTHYROIDISM Because the thyroid hormones influence nearly every organ system, the symp- toms of hyperthyroidism can be wide-ranging and sometimes mistaken for anx- iety or cardiac issues. Common symptoms include: • Rapid or irregular heartbeat (palpitations) • Unexplained weight loss despite normal or increased appetite • Nervousness, irritability, or restlessness • Fine tremors in the hands • Insomnia or difficulty relaxing • Excessive sweating or sensitivity to heat • Frequent bowel movements or diarrhea • Menstrual irregularities • Muscle weakness or fatigue • Menstrual irregularities • Thinning hair or brittle nails • Bulging eyes (in Graves’ disease) Patients might not experience all of these symptoms, and in some cases, they may appear so gradually that they’re dismissed as normal aging or stress. That’s why recognizing the pattern—and knowing when to refer—is so important. OVERVIEW OF THE DISEASE The most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder where antibodies stimulate the thyroid to overproduce hormones. Other causes include toxic nodular goiter, thyroid inflammation, and even excessive iodine intake. Occasionally, over-supplementation of thyroid hormone replace- ment—especially in patients being treated for hypothyroidism—can result in medication-induced hyperthyroidism, known as iatrogenic hyperthyroidism. Though it can affect anyone, hyperthyroidism is most commonly seen in women between the ages of 20 and 50. Left untreated, it can lead to serious complica- tions such as heart disease, osteoporosis, and in rare cases, a life-threatening state known as thyroid storm.
PRESCRIPTION TREATMENTS
Treating hyperthyroidism requires one of three main approaches: medication to reduce hormone production, destruction or removal of the overactive thyroid tissue, or management of symptoms while other treatments take effect. Prescription options include: • Antithyroid medications such as methimazole and propylthiouracil (PTU) work by blocking thyroid hormone synthesis. Methimazole is the preferred agent for most adults, while PTU is typically reserved for the first trimester of pregnancy or for treating thyroid storm. • Beta-blockers, like propranolol, are frequently prescribed to manage the symptoms of hyperthyroidism rather than the disease itself. They help control tremors, palpitations, and anxiety-like symptoms while the anti- thyroid drugs take effect. • In some cases, patients may undergo radioactive iodine therapy, where a single oral dose of iodine-131 selectively destroys overactive thyroid cells. This treatment often results in hypothyroidism, which is then managed with lifelong levothyroxine replacement. • For patients who cannot tolerate medication or who have large goiters or suspicious nodules, thyroidectomy—surgical removal of the thyroid— is another option. Post-surgery, patients also require thyroid hormone replacement for life. Technicians play an essential role in monitoring adherence and ensuring patients understand their dosing schedules. For example, PTU often requires three daily doses, while methimazole is typically taken once a day—making substitution errors easy but dangerous.
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DISEASE BRIEFS | HYPERTHYROIDISM
OVER-THE-COUNTER (OTC) TREATMENT SUPPORT
While no OTC medication can treat hyperthyroidism directly, patients often seek relief from individual symptoms. Artificial tears can help those experi- encing dry eyes due to Graves’ disease, and hydration support may be helpful for those dealing with excessive sweating or diarrhea. Calcium and vitamin D supplements are occasionally recommended to support bone health, especially in patients at risk for thyroid-related bone loss.Pharmacy technicians should remain attentive to repeat OTC purchases that may signal uncontrolled symp- toms and be prepared to alert the pharmacist when needed.
SPECIAL STORAGE REQUIREMENTS
Hyperthyroidism medications are fairly straightforward in terms of storage. Methimazole, PTU, and beta-blockers like propranolol should be stored at room temperature, away from moisture and heat. No refrigeration is required. However, clarity in labeling is still critical—especially for patients prescribed both antithyroid drugs and symptom-managing medications. It’s also important to note that radioactive iodine therapy is not dispensed in traditional outpatient settings. It’s administered under medical supervision, typ- ically in a hospital or nuclear medicine clinic.
COUNSELING POINTS & PHARMACIST ALERTS Although pharmacy technicians don’t provide clinical counseling, they are often the first to spot red flags. A patient refilling methimazole less often than expected, a new report of fever or sore throat, or complaints of rapid heartbeat could signal worsening disease—or dangerous side effects. Agranulocytosis, a rare but serious drop in white blood cells, can occur with antithyroid drugs. If a patient reports flu-like symptoms, immediate pharmacist involvement is essential. Other situations worth alerting the pharmacist include: • A patient becoming pregnant while on methimazole or PTU • Refill gaps or nonadherence to beta-blockers or antithyroid medications • Persistent symptoms despite treatment • New medications with potential interactions (e.g., warfarin)
INSURANCE ISSUES AND TIPS FOR RESOLUTION
Most first-line hyperthyroidism treatments—like methimazole and propran- olol—are available in generic form and covered by most insurance plans. However, technicians may still encounter a few hurdles. One common issue arises when PTU is prescribed for a non-pregnant adult. Since it’s usually considered second-line, some plans may require a prior autho- rization or documented reason for its use. Similarly, when patients are transi- tioning from active treatment to thyroid hormone replacement after surgery or radioactive iodine, their new therapy may require different tiered coverage. Monitoring costs for ongoing labs—TSH, T3, and T4—can also become a bar- rier for patients without comprehensive insurance coverage. Pharmacy techni- cians can offer support by checking plan formularies, flagging non-covered items early, and reminding patients of savings programs for lab testing or brand-name levothyroxine, if needed.
WORKFLOW TIPS FOR TECHNICIANS
Because hyperthyroidism management often includes frequent labs, dose adjust- ments, and sometimes transitions to different therapies, pharmacy technicians play a vital behind-the-scenes role. Double-checking dosing frequency—particularly for PTU—is critical to avoid under-treatment. Watching for frequent early or late refills can also help identify nonadherence or dose confusion. Be sure to flag medication switches or overlap- ping prescriptions for the same condition, and make sure any changes are intentional. When patients begin thyroid hormone replacement, technicians should ensure the start date aligns with thyroid removal or RAI therapy, as timing is essential. Consistent medication supplies, clear labeling, and organized communication with prescribers all support better outcomes.
CONCLUSION
Hyperthyroidism may be an invisible illness to outsiders, but for patients, it can affect every aspect of their daily lives—from how they sleep to how their heart beats. As frontline healthcare professionals, pharmacy technicians are essential in recognizing when therapy is working, when patients need more support, and when something doesn’t seem quite right. With the right knowledge, careful attention to workflow, and strong communi- cation with the pharmacist, technicians help ensure that patients with hyperthy- roidism receive the safe, timely, and effective care they deserve.
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Written by Amanda Abernathy, CPhT, MBA Beyond Interpersonal Conflict
You’re a brand-new pharmacy technician and it’s time for the final check. The prescription is pro- cessed, the medication is dispensed, the package is labeled, and the product is being reviewed by the pharmacist. Do you remember how that feels? The moment is heavy, waiting and wondering if you completed each step correctly. You feel afraid, your palms are sweaty, your heart rate is elevated. High pressure situations, like the conflict of the final check, trigger the physiological response of “fight or flight” resulting in physical responses like sweaty palms, elevated heart rate, rapid breathing, muscle tension and emotional responses like fear or anger1. The “fight or flight” response protects us in emergencies but can make it more challenging to manage the pressure of daily life.
Conflict is unavoidable in the daily operation of a pharmacy. The types of conflict experienced most often in a pharmacy are intrapersonal conflict and interpersonal conflict. Intrapersonal conflict is the struggle a person experiences within themselves. For example, the brand-new pharmacy technician waiting for the final check of their work. Interper- sonal conflict is the struggle a person experiences with another person. For example, co-workers who disagree about job responsibilities, how to com- plete job tasks, and where tools should be stored. These types of conflict typically arise quickly and resolve in a short amount of time. There are two more types of conflict experienced in the pharmacy: intergroup conflict and interorgani- zational conflict. Intergroup conflict is the struggle
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a group experiences with another group. For ex- ample, the pharmacy department and the nursing department in a hospital disagree about the best time of day to perform cart exchange. Interorga- nizational conflict is the struggle an organization experiences with another organization2. For ex- ample, a chain of retail pharmacies disagree with the city transit company over the removal of bus stops near several pharmacy locations. These types of conflict can arise just as quickly as intrapersonal and interpersonal conflict but they typically take a longer amount of time to resolve. Resolution of conflict brings physical and emotion- al relief. Physiological responses like the sweaty palms and fear return to baseline. Resolving con- flict also brings workflow relief. Gaps in communi- cation or flaws in processes have been revealed and addressed allowing operations to return to normal. Resolution and relief can be achieved more quickly in intrapersonal and interpersonal conflict because there are fewer people involved. The larger num- ber of people involved in intergroup and interorga- nizational conflict lead to more possibility of “us- against-them” thinking, ingrained attitudes and
less likelihood of compromise making these types of conflict harder to resolve. Intergroup and interorganizational conflicts place a significant and often unacknowledged strain on pharmacy teams. In these types of conflicts, phar- macy staff can feel compelled to support their group or organization but powerless to make an impact in the situation. This impasse creates pro- longed and/or recurring experiences of the “fight or flight” response. Even though the conflicts between groups and organizations seem insurmountable, there are several strategies that individuals can employ to manage any conflict: competing, accommodating, avoiding, compromising, and collaborating. While all strategies have effective applications, some strategies provide greater satisfaction in a broader range of scenarios. To learn about these management strategies, let’s return to the scenario of the brand-new pharma- cy technician experiencing intrapersonal conflict while waiting for the final check to be completed.
Competing, accommodating, and avoiding provide the least satisfaction in the narrowest range of scenarios.
Competing : One of the parties in the conflict uses power or authority to resolve the conflict to their own satisfaction with no regard for the satis- faction of the other party. To resolve the conflict of waiting, the brand- new pharmacy technician puts pressure on the pharmacist to finish quickly, using their physi- cal power (standing close, staring at the phar- macist, sighing loudly) to apply pressure. Accommodating : One of the parties in the con- flict shows no regard for themselves and resolves the conflict to the satisfaction of the other party. To resolve the conflict of waiting, the brand- new pharmacy technician hides their feelings from the pharmacist to make sure they can complete the final check with no disturbance. Avoiding : One or both of the parties in the con- flict ignore the conflict as if it does not exist. To resolve the conflict pressure of waiting, the brand-new pharmacy technician decides to fo- cus on another work task, pretending the final check is not their work but someone else’s.
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it. The goal for employing management strategies in situations of intergroup and interorganizational conflict is to manage your response to the conflict, relieve the pressure, and reduce or resolve your “fight or flight” response.. With this in mind, let’s explore management strat- egies through our previous example of interorga- nizational conflict; a chain of retail pharmacies disagrees with the city transit company over the removal of bus stops near several pharmacy loca- tions. For this example, we will apply each manage- ment strategy from the perspective of a pharmacy technician working at one of the chain pharmacy locations that is losing bus stops. Just like intrap- ersonal and interpersonal conflict, each strategy provides varying levels of satisfaction in a varying range of scenarios. Competing, accommodating, and avoiding being least satisfactory and in the narrowest range of scenarios, compromising being moderately satisfactory in a moderate range of sce- narios, and collaborating being the most satisfac- tory in the broadest range of scenarios.
Compromising provides a moderate amount of satisfaction in a moderate range of scenarios. Compromising : Both parties agree on a resolu- tion that is partially satisfying to both. To resolve the conflict of waiting, the brand- new pharmacy technician tells the pharmacist that they are anxious for the results. The phar- macist checks faster but feels pressured. The technician receives the results faster, but they still must be uncomfortable while they wait. Collaborating provides the most satisfaction in the broadest range of scenarios. Collaborating : Both parties agree on a resolu- tion that is completely satisfying to both. To resolve the conflict of waiting, the brand-new pharmacy technician tells the pharmacist that they are anxious for the results. The pharmacist involves the pharmacy technician in each step of the checking process, telling them what they did well and where they can improve. Applying these strategies to intrapersonal and inter- personal conflict is straightforward. Applying these strategies to the larger scenarios of intergroup and interorganizational conflict can be harder to visu- alize. When managing intrapersonal and interper- sonal conflict, the goal is to resolve the conflict be- tween the parties. While pharmacy technicians as individuals can make an impact on intergroup and interorganizational conflict, we likely can’t resolve
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