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Neurology

Melatonin: is it worthwhile for sleep?

Melatonin is a naturally occurring hormone that regulates circadian rhythm and sleep. Given its important biological functions,... View Article

January 2024

Tinnitus: the sound of silence

Tinnitus is heterogenous in both its presentation and its causes. It can be frustrating for patients and clinicians as there is... View Article

February 2023

Coeliac disease: investigation and management

Coeliac disease affects approximately 1 in 100 adults. However, it is often unrecognised as symptoms can be vague and non-specific... View Article

August 2022

The medicinal cannabis guide for pharmacists

The Medicinal Cannabis Scheme provides pathways for registered medical practitioners to prescribe quality medicinal cannabis products... View Article

June 2022

An overview of concussion/mild traumatic brain injury management for primary healthcare professionals

Concussion is a form of mild traumatic brain injury (mTBI) resulting from an external force to the head or body that transiently... View Article

April 2022

An overview of medicinal cannabis for health practitioners

Recent regulatory changes will make medicinal cannabis much more accessible to patients. As medicinal cannabis is not a focus... View Article

March 2022

Symptom management in palliative dementia care

Physical symptoms commonly experienced by people with advanced dementia include pain, difficulties with hydration and nutrition,... View Article

April 2020

Understanding the role of palliative care for people with advanced dementia

Advanced dementia is a terminal condition for which palliative care is appropriate, however, knowing when to initiate this process... View Article

April 2020

Managing the behavioural and psychological symptoms of dementia

Most people with dementia develop behavioural and psychological symptoms (BPSD) at some point during their journey, which can... View Article

April 2020

Recognising and managing early dementia

Dementia (mate wareware - see below) is a growing healthcare challenge. There are an estimated 70,000 people with dementia in... View Article

February 2020

Age-related cognitive decline: prevention and future planning

Declining cognitive function can be a difficult topic to raise with patients and their families. It is important to reassure older... View Article

February 2020

The funded brand of lamotrigine is changing

Changes in funded brands of antiepileptic medicines can lead to concern from patients or caregivers that the medicine they are... View Article

August 2019

Balancing the benefits and risks of prescribing antiepileptic medicines in women

Antiepileptic medicines reduce the risk of seizures in people with epilepsy and are sometimes used as part of the management of... View Article

October 2018

Avoiding the triple whammy in primary care: ACE inhibitor/ARB + diuretic + NSAID

Angiotensin converting enzyme (ACE) inhibitors, angiotensin-II receptor blockers (ARBs), diuretics and nonsteroidal anti-inflammatory... View Article

May 2018

Prescribing gabapentin and pregabalin: upcoming subsidy changes

From 1 May, 2018, pregabalin will be available to prescribe, fully subsidised. From 1 June, 2018, prescribing restrictions will... View Article

March 2018

Selected topics in acute pain management for primary care

There are a multitude of causes of acute pain, however, the approach to management will often be similar; assessment guides prescribing... View Article

February 2018

The principles of managing acute pain in primary care

The primary aim of acute pain management is to provide treatment that reduces the patient’s pain, with minimal adverse effects,... View Article

February 2018

Medicinal cannabinoids: current regulations for prescribing

Recent amendments have been made to regulations concerning the prescription of some medicinal cannabis products. For primary care,... View Article

February 2018

Diagnosing and managing headache in adults in primary care

A systematic approach is recommended when assessing patients with headache to rule out serious underlying conditions and to ensure... View Article

December 2017

I dream of sleep: managing insomnia in adults - Part 1

bpacnz recognises that the assessment and management of insomnia in general practice can be difficult, especially in relation... View Article

October 2017

I dream of sleep: managing insomnia in adults - Part 2

bpacnz recognises that the assessment and management of insomnia in general practice can be difficult, especially in relation... View Article

October 2017

Helping patients with epilepsy adhere to their medicines

People with epilepsy require good adherence to anti-epileptic medicines for optimal seizure control. However, maintaining good... View Article

September 2017

Managing patients with neuropathic pain

Neuropathic pain results from a lesion or disease affecting the somatosensory system. There are a range of causes of neuropathic... View Article

May 2016

Melatonin: is it worth losing any sleep over?

Modified-release melatonin is an unsubsidised medicine that is approved for, and moderately effective at, improving sleep quality... View Article

August 2015

Medicine updates

This article has been archived. If you would like access to the original article please contact: [email protected] View Article

December 2014

The role of triptans in the treatment of migraine in adults

Paracetamol or a non-steroidal anti-inflammatory drug (NSAID) can be used first-line for pain relief in acute migraine. A triptan... View Article

July 2014

The management of Parkinson’s disease: Which treatments to start and when?

The treatment of patients with Parkinson’s disease usually involves a multidisciplinary approach to care. The role of the general... View Article

February 2014

Managing patients with dementia: What is the role of antipsychotics?

Concerns have been raised, both in New Zealand and internationally, about the increasing off-label use of antipsychotics, and... View Article

December 2013

Hazardous substances series: Pyrethroid toxicity and its management

Contributed by Dr Michael Beasley and Dr Wayne Temple, National Poisons Centre View Article

December 2013

Multiple sclerosis: Managing shades of grey

Multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS) resulting in neurological deficits, which... View Article

August 2013

H1N1 influenza vaccination and the risk of childhood narcolepsy

IN MARCH, 2012 A SIGNIFICANT INCREASE in the rate of childhood narcolepsy associated with the influenza vaccine Pandemrix (GlaxoSmithKline)... View Article

April 2013

The night time hustle: managing restless legs syndrome in adults

Restless legs syndrome is a common neurological disorder that can significantly affect a patient's quality of life. Lifestyle... View Article

December 2012

Sleep disturbances: managing parasomnias in general practice

The term "parasomnia" describes a group of sleep disorders associated with unnatural movements, behaviours, emotions, perceptions... View Article

November 2012

Silencing tinnitus

Tinnitus is the perception of sound within the ear or head, without a corresponding external stimulus for that sound. It is a... View Article

October 2012

A delicate balance: managing vertigo in general practice

Vertigo is a symptom, not a diagnosis. Although usually benign, vertigo can be a symptom of a significant underlying problem.... View Article

September 2012

Prescribing atypical antipsychotics in general practice

The use of atypical antipsychotics such as quetiapine and olanzapine is increasing. In many cases, these medicines are used for... View Article

November 2011

Raynaud's phenomenon: a whiter shade to winter's pale

Raynaud's phenomenon is a circulatory disorder, characterised by episodic attacks where arteries in the fingers and toes spasm,... View Article

August 2011

The fear of enabling; misuse of prescription medicines

Misuse of prescription opioids is increasing worldwide and many doctors are becoming reluctant to prescribe these medicines for... View Article

June 2011

Investigating mercury toxicity

Although there are many potential sources of exposure to mercury and its compounds, most people can be reassured that they are... View Article

November 2010

The pharmacological management of Alzheimer’s disease: The place of donepezil

From November 1, 2010 donepezil will be funded without Special Authority, on the Pharmaceutical Schedule. Donepezil and other... View Article

August 2010

Snippets: Dextropropoxyphene & Donepezil

Donepezil to be funded on pharmaceutical schedule | Dextropropoxyphene - finding alternatives View Article

July 2010

Snippets: Gabapentin Humalog & Tramadol

Humalog, Tramadol and Gabapentin View Article

June 2010

Prescribing issues associated with anticonvulsant medications for epilepsy

The goal of successful pharmacological treatment in epilepsy is the complete control of seizures, however for some people this... View Article

November 2009

Having a senior moment?

Differentiating normal age-related memory loss from early onset dementia Normal age-related memory loss affects everybody. Assessing... View Article

September 2009

Five-minute back examination with neurological assessment

Instructions and illustrations for performing a quick examination on a patient presenting with acute low back pain and neurological... View Article

June 2009

Medication-overuse headache: when the cure becomes the cause

Medication-overuse headache is a complex disorder best described as an interaction between a therapeutic agent used excessively... View Article

September 2008

Pharmacological management of neuropathic pain

The treatment of neuropathic pain involves a different step-wise approach. View Article

September 2008

The problem of pain memory: persistent central sensitisation pain

Pain memory occurs when the nervous system has become up-regulated from a previous trauma or severe pain. This is a particularly... View Article

September 2008

Managing insomnia

There is a more recent article on managing insomnia. See: I dream of sleep: managing insomnia” https://bpac.org.nz/2017/insomnia-1.aspx Insomnia... View Article

June 2008

Dilemmas: Recognition and treatment of pain in elderly people

Chronic pain is common in elderly people, however it is often unrecognised, treated sub-optimally or not treated at all. Regular... View Article

February 2008

Snippets: Drug information of topical interest


• Calcium Supplementation and the risk of myocardial infarction
• Use of eGFR for drug dose adjustment
• Compulsive gambling...
View Article

December 2007

Dear Dave

Do timolol eye drops cause cold extremeties and tiredness?Dave discusses the systemic absorption of drugs from eye drops and ways... View Article

October 2007

Headache in primary care

Advice on diagnosis and management of primary headaches View Article

August 2007

Parkinson's disease

Covers diagnosis and management of Parkinson's disease View Article

August 2007

CARM Reports; Serotonin Syndrome and Neuroleptic Malignant Syndrome

Covers the symptoms and causes of Serotonin Syndrome and Neuroleptic Malignant Syndrome View Article

February 2007

Dear Dave

Can smoking cessation affect the dose of antipsychotics?Do statins cause nightmares?How important is it to give simvastatin at... View Article

February 2007

Practice Debate: antipsychotics in the treatment of dementia

This article covers the role and safety concerns of antipsychotics in the treatment of behavioural and psychological symptoms... View Article

February 2007