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The present study attempts to investigate the anticonvulsant activity and pharmacodynamic interactions of Lamotrigine withPhenytoin and Sodium valproate in maximal electroshock (MES) induced seizures on males Sprague Dawley (SD) rats.Seizures were induced in SD rats (100-200 g) by delivering maximal electro shock of 150 mA for 0.2 sec by means of aconvulsiometer through a pair of ear clip electrodes. The test compounds [Phenytoin (25mg/kg), Sodium valproate(300mg/kg)] and Lamotrigine (18mg/kg) were administered by oral route one week before and an hour before the MES testrespectively. The animals were observed closely for 2 mins. The percentage of inhibition of seizure by measuring the timetaken behavioral relative to control was recorded and calculated. Phenytoin (100 mg/kg) was used as a standard drug. Thedata was analysed by using one way ANOVA. As per the observation, the Lamotrigine along with the sodium valproateshows more significant variation than that of the Lamotrigine with the Phenytoin when compared with that of theLamotrigine alone. All the three groups (groups-1,2,3) of drugs shows more variation compared with control group (group-1). The increased levels of the Lamotrigine in case of Group-3 (enzyme inhibitor) may increase the risk of adverse effects,whereas decreased levels of Lamotrigine in case of Group-2 (enzyme inducer) may automatically decrease the antiepilepticactivity of Lamotrigine. So, it is fore most important to have Therapeutical Drug Monitoring (TDM) of Lamotrigine duringits concomitant use throughout the therapy.

Phenytoin is an anticonvulsant which is extensively used in controlling generalized tonic-clonic seizures as well as simpleand complex partial seizures. Phenytoin acts mainly by prolonging the inactivated state of sodium channel, therebyextending refractory period of neurons and also limiting the repetitive firing of action potentials. Bioavailability ofphenytoin varies widely in terms of pharmacokinetic variability. Consequently, the narrow therapeutic window of phenytoinfrequently causes adverse effects as well as toxicity. Phenytoin when given at higher doses is associated with variousvestibular and cerebellar side effects like motor ataxia, muscle spasms, psychoses and visual disturbances. Long term use ofphenytoin at therapeutic and toxic levels can lead to Epilepsy. However, phenytoin-induced cerebellar syndrome isreversible with timely withdrawal of medication. Regular monitoring of plasma concentrations, accurate dosing, andmedication adherence to treatment regimens are very important. Here, we report a case of phenytoin-induced Epilepsypresenting with behavioral abnormalities, paraparesis and visual impairment. The patient’s condition improved by graduallytapering the dose, followed by termination of phenytoin therapy and substitution with carbamazepine. This reportemphasizes on the importance of regular monitoring of plasma drug concentration, accurate dosing of drugs having a narrowtherapeutic index, and identification of noncompliance in patients treated with phenytoin.

Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia which is mainly due to the disturbances in carbohydrate, protein and fat metabolism leading to the dysfunction and failure of various organs. Aims and Objective: To compare the behavior of anti-diabetic drugs given in two combinations in patients with diabetes mellitus type II and compare the drug reliability. To assess the safety and efficacy of metformin plus glimepiride in patients with type II diabetes mellitus. To study the safety and efficacy of metformin plus voglibose in diabetes mellitus type II patients. Methods: One Hundred and eight patients who met the inclusion criteria were enrolled into the study. A total of 100 patients completed all the follow up visits. Patients enrolled were known case of diabetes mellitus type II, with no co morbid conditions and have been administered with either of the drug combinations of our study. The mean ±SD age of patients in the study was 53.51±9.4920795. The mean age of Group-A patients is 52.5 while it is 54.5 in Group-B patients. The percentage of male patients is higher in group-B whereas it is vice versa in case of female patients. The baseline demographic parameters of Group -B (Metformin +Voglibose) patients have been given. Conclusion: Diabetes mellitus has been alarming globally with 1.2million of new patients in south Asian continents. Altered Quality of Life (QOL) is the major consequence of it, crippling the public health. To treat diabetes mellitus type II, proper assessment of patient's glucose profile is key to start treating the diabetes. When compared between metformin plus glimepiride and metformin plus voglibose, the former combination is better in terms of efficacy.