Question

You are at one of your clinical placements with a school nurse. A parent walks into the office and asks to speak to the nurse. The school nurse introduces you to the parent and offers your assistance. The parent says, “My son is John Smith. He is 8 years old and a student in Mr. Albright’s class. The doctor put him on Ritalin. I’m not sure how I feel about this. He has been on it for 10 days now. I have some questions I’d like to ask you.”

1. The parent continues, “John weighs 62 pounds. My friend’s son went on Ritalin and lost weight. Do you think this will happen to John?” How should you respond?
2. John’s parent says, “You know, John doesn’t seem much better to me. He doesn’t want to take the pills, so I give him a treat to persuade him to take them. In the morning I give him the Ritalin with a hot cup of tea with sugar because he likes hot tea. At night, before he goes to bed, I give him the Ritalin with hot chocolate because he likes that, too. He doesn’t sleep; he’s up until 2:00 a.m. Why aren’t the pills making it easier for him to sleep?” How should you respond?
3. The parent states, “I’m just going to stop the pills. I don’t care what the doctor says. I think the pills aren’t good for him.” How should you respond?

Answer 1

1. The drug Methylphenidate has been sold under the trade name Ritalin. It is used in the treatment of Attention Deficit hyper activity Disorder (ADHD) kids and adults.Ritalin acts as the stimulant of the central nervous system.The common side effects of Ritalin are loss of apetite, loss of weight, nausea, voimiting, insomnia.

2. Ritalin and weight loss

3. Every child may not lose weight.Coming to the weight loss of your friends son, yes Ritalin does weight loss and apetitie loss but you can overcome this problem by giving Ritalin after breakfast and keeping the next dose of drug until dinner in away drug effect can be minimized.Provide him nutrient rich breakfast so that he can get everything in single serve. If john loses more than 10 % of weight loss then doctor can prescribe other type of meications too.
4. Ritalin and sleeplessness
5. Please take the medication in the early hours of the day so that the side effects of the drug are least by the time John goes to sleep.
6. If john is on long acting medication consult the doctor to change into the short acting medication so the effects are minimized.
7. When stimulants like Ritalin is taken should not be given with other stimulants like caffeine.
8. The usage of caeffine should be avoided or minimized otherwise it results in trouble sleeping.
9. Atleast one hour before going to bed all the electronic gadgets have to be switched off and take time to relax so that John goes to sleep without any trouble.
10. Ritalin and withdrawal symptoms
11. If you suddenly stop taking this medication without doctors advice John may experience some withdrawal symptoms like depression, behavioural changes, mood swings and suicidal thoughts.Doctor will decrease the dose gradually before stopping the medication. Please don't discontinue the medication without doctor's advice.
12. Follow all the above mentioned steps so that John experiences positive effect of the Ritalin.