Q. When working in pediatric medicine several years ago, I remember a 3-year-old child who became psychotic because a child psychiatrist gave him methylphenidate (Ritalin). The child did not sleep for three days, and when he was brought into our clinic, he was screaming that snakes were all over his body.

Needless to say, the psychiatrist was reprimanded by the state health department. First and foremost, no physician should ever give a 3-year-old ADHD medication. If a child hasn’t slept for three days, we should expect them to have serious symptoms.

A. The Food and Drug Administration has approved short-acting Ritalin for children at least 6 years old. Thank you for reminding us that very young children require special oversight when it comes to medications.

Q. In the U.K., my daughter is prescribed Primatene Mist inhaler for anaphylaxis (life-threatening allergic reaction). She also has an EpiPen injector, but the inhaler is a vital part of her emergency medical kit. I am glad that this medicine can be purchased without a prescription in the United States.

A. Inhaled epinephrine (adrenaline) was a mainstay of asthma treatment for almost a century. Primatene Mist was marketed in the U.S. starting in the 1960s. Doctors also use epinephrine to counteract severe allergic reactions such as anaphylactic shock. They usually administer it by injection to achieve a fast response.

People who are highly allergic to stings, peanuts or other allergens often get a prescription for a self-injector such as an EpiPen or AUVI-Q. There is another option. Neffy is epinephrine in a nasal spray. It is available only by prescription for severe allergic reactions. Anyone experiencing anaphylaxis must seek immediate medical attention.

Q. My husband and I have two friends with significant disabilities largely due to spinal fractures as a result of osteoporosis. One man was always an avid exerciser, including running marathons. Both men are more than 6 feet tall and have always appeared to be muscular.

My husband is shorter and is physically active, playing tennis and going to the gym regularly. Because of our friends’ bone issues, I advised him to request a DXA scan to assess his bone health. The nurse practitioner told him that it was not recommended for men.

I am still concerned that he may be at risk for osteoporosis. Are there medical studies that determine the risk factors for men?

A. The nurse practitioner was mistaken. Men can develop osteoporosis, as your friends discovered.

Many medical guidelines recommend that men over age 70 be tested with a DXA scan to assess bone health. If your husband has low testosterone levels or has taken medications such as prednisone, he could be at increased risk for fractures.

Q. Plantar fasciitis interferes with my ability to exercise. Using Voltaren Gel morning and night has helped a lot. I’ve never had any blood pressure issues. I do have stomach upset with oral NSAIDs. What should I know about Voltaren?

A. Although topical NSAIDs such as Voltaren Gel are less likely to irritate the digestive tract or raise blood pressure, some people do report these side effects. Experts have found that topical NSAIDs offer good pain relief with few serious complications. The FDA warning can be quite scary, though.

You can learn more about the pros and cons of Voltaren Gel in our “eGuide to Alternatives for Arthritis.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”