A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be "in his system" when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions?
The last dose of medication should be given 4 to 6 hours before bedtime to diminish insomnia.
The medication should be taken with meals for optimal absorption.
The medication should not be taken until he is at school.
She is giving him the medication dosage appropriately.
The Correct Answer is A
A. The last dose of medication should be given 4 to 6 hours before bedtime to diminish insomnia: Methylphenidate is a stimulant medication commonly used to treat ADHD.
Administering it at bedtime may interfere with sleep onset and lead to insomnia. It's important to follow the prescribed dosing schedule to optimize symptom control during waking hours while minimizing adverse effects on sleep.
B. The medication should be taken with meals for optimal absorption: While taking
methylphenidate with meals may help reduce gastrointestinal side effects, the timing of administration relative to bedtime is more relevant to address in this scenario.
C. The medication should not be taken until he is at school: Delaying medication until the child is at school may result in inadequate symptom control during the morning when ADHD
symptoms are often most problematic.
D. She is giving him the medication dosage appropriately: Administering methylphenidate at bedtime is not appropriate and may lead to insomnia rather than optimizing symptom control during the day.
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Related Questions
Correct Answer is D
Explanation
A. Tachycardia is not typically associated with cholinergic drug effects. Cholinergic stimulation tends to slow down the heart rate rather than increase it.
B. Palpitations may occur with certain cardiac arrhythmias or in response to sympathetic stimulation, but they are not typically associated with cholinergic drug effects.
C. Cholinergic drugs are more likely to cause vasodilation rather than vasoconstriction.
Therefore, vasoconstriction is not a common cardiovascular effect of cholinergic drug therapy.
D. Bradycardia is a common cardiovascular effect of cholinergic drug therapy. Cholinergic stimulation slows down the heart rate by increasing parasympathetic activity, particularly at the
sinoatrial (SA) node. Therefore, bradycardia is the cardiovascular effect that nurses should monitor for when administering cholinergic drugs.
Correct Answer is A
Explanation
A. Carbidopa prevents the breakdown of levodopa in the periphery, specifically in the gastrointestinal tract and peripheral tissues, allowing more levodopa to reach the brain and be converted to dopamine. This enhances the effectiveness of levodopa therapy in managing the symptoms of Parkinson's disease.
B. Carbidopa is not the biologic precursor of dopamine. It is a peripheral decarboxylase inhibitor that does not cross the blood-brain barrier.
C. Carbidopa does not directly allow for larger doses of levodopa to be given. However, by
inhibiting the peripheral breakdown of levodopa, it enhances the availability of levodopa to the central nervous system, potentially improving therapeutic efficacy.
D. While levodopa-carbidopa combination therapy may have fewer drug-food interactions compared to levodopa alone, the primary reason for combining these medications is to enhance the effectiveness of levodopa by preventing its peripheral breakdown.
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