November 29, 2022

This episode of Drug Talk features a medication commonly used to treat ADHD and goes by the name of methylphenidate or Ritalin, Biphentin & Concerta.

Hey everybody welcome back to drug talk this is episode 18 as always i’m your host garrett campbell today we’re going to be discussing the medication known as methylphenidate or more commonly known as by its brand name ritalin with this particular medication there is actually two other brand names that you can find methylphenidate in these being by fenton and

Concerta and we’ll touch on these both the video as well so methylphenidate is classified as a psycho stimulant and it’s commonly used to treat a dd or adhd so attention deficit disorder as well as attention deficit hyperactive disorder so methylphenidate or ritalin is available in two forms one of them being the immediate release form and then as well there’s

A sustained release form so the sustained release form gradually releases the medication over time or the immediate release medication releases it all at once the immediate release form is available as a 5 milligram a 10 milligram as well as a 20 milligram tablet and with the slow release form we usually see that as a 20 milligram tablet this medication works by

Blocking the reuptake of a neurotransmitter known as dopamine now before this medication is prescribed to an individual by their physician there are some precautions that must be reviewed just to ensure that the medication is prescribed appropriately physicians will use precaution prescribed as medication to individuals who have cardiovascular disease now this can

Range from heart failure recent myocardial infarction or heart attack it can be if somebody has increased blood pressure or even some qt syndromes caution will also be used when prescribing to individuals who have a history of drug abuse or alcohol abuse because this medication does have the potential to be abused on its own this medication may worsen the symptoms

Of psychosis it can have a negative effect on hyperthyroidism they must be prescribed cautiously in individuals with epilepsy as it may decrease the seizure threshold and finally it should be used cautiously or sometimes avoided in individuals who have severe depression moving now from precautions to contraindications or reason that this medication cannot be

Used by an individual some of these commonly noted contraindicate our anxiety or agitation advanced arteriosclerosis systemic cardiovascular disease a barely increased blood pressure it’s contraindicated in people who have glaucoma patients with motor tics or family history or diagnosis of tourette’s syndrome and finally the use of a mono aiming oxidase inhibitor

In the last 14 days now i mentioned at the start of the video that this medication is used in adhd it is reserved for patients that are equal to or greater than the age of 6 years old i also mentioned that it comes as two forms so the immediate release version as well as the slow release these can also be classify the short acting as well as intermediate action

The short acting formulation usually lasts around 3 to 5 hours on average the intermediate acting lasts three to eight hours there is a wide range here but you have to keep in mind that there is variability between individuals it is common to see people start off using a short acting version which can be taken twice or three times a day but depending on patient

Preference or physician experience with this medication oftentimes people will be switched over to the intermediate acting medication when the short acting version is used in adolescents a typical dose would be 5 milligrams in the morning as well as 5 milligrams at noon however we can see doses all the way up to 20 milligrams taking 3 times a day so the maximum

Dose here would be 60 milligrams daily it’s common to see adults start off at 10 milligrams in the morning and 10 milligrams at noon and the max dose can go a little bit higher occasionally i don’t want to talk too much about dosing with this particular medication because as i mentioned earlier the dosing does vary from individual to individual as well there’s

A lot of different dosing strategies that can be used for example one strategy known as a kickstart and avoid noon dosing as patients use a intermediate acting alongside with a short-acting tablet both in the morning or the rebound method which has patients use a slow release version in the morning and then use an immediate release version in the afternoon now

When somebody is using this medication there are some things that should be monitored during the course of therapy symptoms in general will be monitored at each physician appointment and preferably but each visit to the pharmacy if appropriate academic performance maybe monitor physicians will sometimes perform a physical exam on the patient and then things like

Blood pressure and heart rate will be monitored as well usually on day zero day one and then about the three-month mark and then after that every half to one year echocardiograms will sometimes be done as a monitoring parameter but this is usually reserved for people who have a family history of cardiovascular disease or if they’re in a particular population

Which would be deemed at risk and lastly some patients will get some blood work done periodically when they’re using the medication long term now if somebody is using this medication there are some side effects that they may experience so i’ll list some of them for you now insomnia or difficulty sleeping happens in about 13% of individuals 26% of the time you

Can see a decrease in appetite nausea comes in at about 12% and vomiting at 10% weight loss happens about 9% of the time and about 7% of people notice a tick emotional instability happens in about 6 percent of people anorexia in 5% interestingly nasal congestion happens in about 6% of people and some people may notice some headaches as well some serious side

Effects would be angioedema hallucinations or blood dysplasias now lastly before enough the video is want to mention two other medications which are still methylphenidate just different formulations so that will be by fenton and concerta so these are long-acting versions of methylphenidate not to distinguish between the two by fenton has a multi-layer delivery

System this causes 40% of the medications be released immediately and then the remaining 60% to be released gradually throughout the day now conservator has an osmotic release oral system which causes 22% of the medication to be released immediately and the remaining 78% gradually throughout the day by fenton usually lasts about 10 to 12 hours and concerta lasts

About 8 to 12 hours now these long-acting versions can be more convenient for some people it really just depends on patient preference as well as the clinical experience of the physician who’s doing fryman that’s all we’re gonna talk about today with methylphenidate or riddlin as always i appreciate everybody stopping by and checking out my videos if you’d like

To help the channel grow you can like the videos share the videos or subscribe to the youtube channel always remember that these videos are for information purposes only and not to guide you in making any decisions on your personal health care if you have any questions about the medication just directed towards your personal health care provider that’s it for today take care

Transcribed from video
METHYLPHENIDATE (RITALIN) – PHARMACIST REVIEW – #18 By Drug Talk