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) Taking care: the different areas of medicine safety
In its landmark Medicine Safety: Take Care report, PSA identified the frightening cost of medicine misadventure in Australia. With medicines safety a central theme...
Q&A: Federal Assistant Minister for Health David Gillespie
Australian Pharmacist spoke with Dr David Gillespie MP, the Federal Assistant Minister for Health, about his experiences and engagements with pharmacists during his medical...
Choosing wisely: sedatives
In the third of a six-part series, we expand on the PSA Choosing Wisely recommendations, taking a closer look at the use of sedatives....
GPs use antibiotics as placebos: study
Most Australian GPs have used a placebo in practice at least once, with active placebos used far more than inert placebos, a new study...
Experts urge support for PrEP after second Australian HIV case
Experts are emphasising the efficacy of the revolutionary pre-exposure prophylaxis (PrEP) medicine after a recent case of a Sydney man contracting HIV while taking...
Australian asthma deaths fall, mostly in women: ABS
The National Asthma Council has highlighted the vital role community pharmacists can play in identifying at-risk patients, following a drop in overall asthma deaths...
