The client has fallen off his mountain bike and sustained multiple abrasions to both of his knees. Which would be appropriate medication(s) for pain management for this client? (Select All That Apply)

A. Before breakfast or lunch

Methylphenidate (Ritalin), a stimulant medication commonly used to treat attention deficit hyperactivity disorder (ADHD), is usually administered before breakfast or lunch for maximum effectiveness. This schedule helps align the peak concentration of the medication with the times when increased focus and attention are often needed, such as during school hours.

B. With meals

While it can be administered with meals, the goal is often to have the medication take effect before meals to help with focus and attention during activities like school or work.

C. After dinner

Administering methylphenidate after dinner may interfere with the patient's ability to fall asleep, as the medication can cause insomnia. It is generally recommended to avoid administering it in the late afternoon or evening.

D. At bedtime

Administering methylphenidate at bedtime is not appropriate due to the potential for insomnia. The stimulant effect of the medication is not aligned with the patient's sleep-wake cycle.

A. Increase the amount of dopamine and reduce the amount of acetylcholine:

This is the correct answer. Parkinson's disease is characterized by a deficiency of dopamine, so medications aim to increase dopamine levels. Additionally, reducing the activity of acetylcholine helps to restore the balance between these neurotransmitters.

B. Increase the amount of dopamine and acetylcholine:

This is not accurate. Increasing both dopamine and acetylcholine would not address the underlying imbalance seen in Parkinson's disease.

C. Reduce the amount of dopamine and increase the amount of acetylcholine:

This is incorrect. Parkinson's disease involves a reduction in dopamine levels, so reducing dopamine further would worsen the symptoms. Additionally, increasing acetylcholine is not the therapeutic goal in Parkinson's disease.

D. Reduce the amount of dopamine and acetylcholine:

This is not the correct approach. Decreasing both dopamine and acetylcholine would exacerbate the symptoms of Parkinson's disease, as the primary issue is the deficiency of dopamine.