Medication review brief · for the pharmacist
Omar Ferreira
94 · male · Hypertension, Type 2 diabetes, Osteoarthritis pain
Prepared by Domino · Oct 1, 2026
Summary
1 likely prescribing cascade link. If Lisinopril were reviewed, up to 1 downstream medicine might no longer be needed (4 → 2).
Question 1
Could the dry cough be from the ACE inhibitor? Cough suppressants do not fix it; switching to an ARB usually does.
- Lisinopril (Aug 30, 2023) → persistent dry cough → Dextromethorphan (Sep 7, 2023) · likely 0.99 · study
If reviewed: Dextromethorphan; medicines 4 → 2; anticholinergic burden 0 → 0; fall-risk drugs 2 → 0.
Medicines
| Medicine | Started | Charted for | Domino |
|---|---|---|---|
| Acetaminophen as prescribed Dr. H. Singh (family doctor) | May 10, 2023 | Osteoarthritis pain | |
| Lisinopril as prescribed Dr. H. Singh (family doctor) | Aug 30, 2023 | Hypertension | Root of a cascade |
| Dextromethorphan as prescribed Dr. T. Nguyen (walk-in clinic) | Sep 7, 2023 | Dry cough | Possibly treating a side effect |
| Sitagliptin as prescribed Dr. H. Singh (family doctor) | Oct 17, 2023 | Type 2 diabetes |
Evidence
- Vegter S, de Jong-van den Berg LTW. Misdiagnosis and mistreatment of a common side-effect: angiotensin-converting enzyme inhibitor-induced cough. Br J Clin Pharmacol. 2010;69(2):200-203.
Decision support only. Domino flags patterns in a synthetic record for a clinician to review; it does not diagnose, and it never recommends stopping or changing a medicine. Synthetic data; no real patient.