Frank Russo

82 · male · Type 2 diabetes, Neuropathic pain, Bipolar disorder

Some links are deliberate. Domino remembers which.

Medicines

Likely cascade links

Could be avoidable

Anticholinergic burden

Drugs toward falls

Dangerous combos

Root drug · likely · score 0.96

Gabapentin → 2 downstream

Gabapentin

Gabapentinoid

Furosemide

Loop diuretic

Potassium chloride

Potassium supplement

Root drug · possible · score 0.34

Lithium

Mood stabiliser

Propranolol

Beta blocker

Why Domino thinks so

Gabapentin started Jul 19, 2024 · Furosemide started Sep 3, 2024

0.99

likely

How often it causes this×0.7Peripheral edema is common with Gabapentin.

Timing×1Furosemide started 7 weeks after Gabapentin, inside the usual window for peripheral edema (7 to 90 days).

Other reasons×1.25Furosemide was charted for peripheral edema.

Published evidence×1.15Matches a documented cascade backed by a published study.

Gabapentinoid → ankle swelling → loop diuretic

Evidence: published study

Read SH, et al. Evidence of a gabapentinoid and diuretic prescribing cascade among older adults with lower back pain. J Am Geriatr Soc. 2021;69(10):2842-2850.

Question for the pharmacist: Could the swelling be from gabapentin or pregabalin?

Teach Domino. Your decision becomes memory every future review respects.

Checked and set aside

Analysis: 10 FalkorDB queries, run in parallel, 25 ms