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37.(a, b, e) Tegretol (Carbamazepine) is classified as 38. (c) The active metabolites of Mysoline
an antiepileptic drug. It is indicated for: (Primidone) are Phenobarbital and
Phenylethylmalonamide (PEMA).
1. Partial seizures with complex symptomatology
(psychomotor, temporal lobe). Patients with these Primidone per se has anticonvulsant activity as do
seizures appear to show greater improvement than its two metabolites, phenobarbital and
those with other types. phenylethylmalonamide (PEMA). In addition to its
anticonvulsant activity, PEMA potentiates the
2. Generalized tonic-clonic seizures (grand mal). anticonvulsant activity of phenobarbital in
experimental animals.
3. Mixed seizure patterns which include the above,
or other partial or generalized seizures. Mysoline (Primidone), used alone or concomitantly
with other anticonvulsants, is indicated in the
4. Absence seizures (petit mal) do not appear to be control of grand mal, psychomotor, and focal
controlled by Tegretol. epileptic seizures. It may control grand mal seizures
refractory to other anticonvulsant therapy.
5. Pain associated with true trigeminal neuralgia
and glossopharyngeal neuralgia. For most adults and children 8 years of age and
over, the usual maintenance dosage is three to four
6. Alcohol withdrawal treatment. It rapidly relieves 250 mg Mysoline tablets in divided doses (250 mg
anxiety and distress in acute alcohol withdrawal t.i.d. or q.i.d.). If required, an increase to five or six
treatment. 250 mg tablets daily may be made but daily doses
should not exceed 500 mg q.i.d.
7. Acute manic and mixed episodes associated with
Bipolar I Disorder (Equetro). Ataxia, fatigue, hyperirritability, vertigo, diplopia
and nystagmus are principal side effects of the drug.
The usual recommended therapeutic dose of drug is
800 mg to 1200 mg per day in two to four divided The normal therapeutic serum concentration range
doses (depends on a formulation). for Phenobarbital is 10 and 20 mcg/ml. It generally
enhances the metabolism of other drugs by its
Aplastic anemia and agranulocytosis are reported enzyme induction property. Mysoline is available in
side effects of the drug. oral tablet and suspension form.

It is available in tablet, chewable tablet, suspension, 39. (a) One of the active metabolites of Mysoline is
extended release tablet form and extended release Phenobarbital. It should be avoided by Chris
capsule form (under the brand name of Carbatrol because of his (phenobarbital allergy) problem.
and Equetro)
40.(e) Tegretol, Carbatrol and Equetro are brand
The normal therapeutic serum concentration of the names of Carbamazepine, which is structurally
drug should lie between 10 and 20 mcg/ml. Because related to tricyclic antidepressant Elavil
it is structurally related to tricyclic antidepressants, (Amitriptyline). They should be carefully prescribed
it should be carefully used by patients to patients hypersensitive to tricyclic
hypersensitive to tricyclic antidepressants (TCAs). antidepressants (TCAs).

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