Table 1 – Types of vertigo (non-exhaustive list)[/caption]
Vomiting
In older people, dizziness significantly increases the risk of falls.7 Implementing appropriate interventions to address modifiable risk factors such as dizziness is of paramount importance. In cases of drug-induced dizziness, deprescribing can be considered if the medicine can be safely reduced, discontinued or substituted to prevent inappropriate prescribing cascades of potentially inappropriate medicines (PIM), especially in the context of older people.29
A national education program for pharmacists funded by the Australian Government under the Quality Use of Diagnostics, Therapeutics and Pathology program.[/caption]
The hypothalamus houses neurons that produce neuropeptides called orexin A and B, which were discovered in 1998, and represent one of the most exciting discoveries in sleep medicine.5,13–15 Orexin-producing neurons help us stay awake and alert, especially when we really need to focus, which is critical for survival.5,14 These neurons reach out to many brain areas that use other wakefulness messengers such as acetylcholine, dopamine, histamine, serotonin and noradrenaline. These areas ‘talk back’ to the hypothalamus, to further boost wakefulness signals.5 Similarly, the thalamus is an important region that also serves to relay wakefulness signals from the RAS.5
Another dual orexin receptor antagonist (DORA), vornorexant*, is under development and currently undergoing clinical trials.28 
Other medicines such as dimdazenil* (partial positive allosteric modulator at GABAA specific to alpha-1 and alpha-5 GABAA receptor subtypes)41 and zuranolone* (positive allosteric modulator for GABAA) have also been tested, with positive outcomes in trials. Zuranolone* is marketed overseas specifically for postnatal depression, but clinical trials for its use in insomnia are ongoing.40
Kristy Carter (she/her)
Louise Edwards (she/her) New CAL medicine storage guidance
Both Cautionary Advisory Label (CAL) 6 and CAL 13 have been overhauled to sharpen storage advice.
CAL 6 explanatory notes advice in Digital Australian Pharmaceutical...
Pharmacist-led medicine substitutions now possible
In an Australian first, pharmacists can now adapt prescriptions to solve problems with medicines – no doctor sign-off required.
Immediate-release melatonin for jet lag
The Therapeutic Goods Administration (TGA) has down- scheduled – to Schedule 3 Pharmacist Only – immediate-release melatonin preparations for the treatment of jet lag in adults aged 18 years or older.
Patient death sparks turmeric and curcumin concerns
After 18 reports of liver injury, including one death, the TGA has issued a warning about the risks of taking turmeric and/or curcumin.
This is how patients should taper off all psychiatric medicines
This individualised approach to tapering off psychiatric medicines can help patients withdraw for good, said Dr Mark Horowitz at PSA24.
Are you prepared for the paracetamol regulation changes?
At the end of this month, new pack sizes will start to arrive in pharmacies – ahead of the impending scheduling change of paracetamol.
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