Arthur Russo

87 · male · Type 2 diabetes, Heart failure, High cholesterol

Prepared by Domino · Oct 1, 2026

Summary

1 likely prescribing cascade link. If Furosemide were reviewed, up to 2 downstream medicines might no longer be needed (6 → 3).

Question 1

Could the urgency or leaking be from the diuretic? Changing the timing of the dose can help before adding a bladder medication.

Furosemide (Jul 27, 2024) → leaking urine, urgency → Mirabegron (Oct 24, 2024) · likely 0.99 · consensus
Mirabegron (Oct 24, 2024) → high blood pressure → Doxazosin (Oct 31, 2024) · possible 0.34 · graph-inferred

If reviewed: Mirabegron, Doxazosin; medicines 6 → 3; anticholinergic burden 2 → 1; fall-risk drugs 3 → 1.

Medicines

Medicine	Started	Charted for	Domino
Furosemide as prescribed Dr. H. Singh (family doctor)	Jul 27, 2024	Heart failure	Root of a cascade ACB +1 Beers-listed
Metformin as prescribed Dr. H. Singh (family doctor)	Aug 3, 2024	Type 2 diabetes
Metoprolol as prescribed Dr. H. Singh (family doctor)	Aug 13, 2024	Heart failure	ACB +1
Mirabegron as prescribed Dr. T. Nguyen (walk-in clinic)	Oct 24, 2024	Urinary incontinence	Possibly treating a side effect
Doxazosin as prescribed Dr. R. Ahmed (walk-in clinic)	Oct 31, 2024	—	Possibly treating a side effect Beers-listed
Atorvastatin as prescribed Dr. H. Singh (family doctor)	Dec 31, 2025	—

Evidence

McCarthy LM, et al. ThinkCascades: A Tool for Identifying Clinically Important Prescribing Cascades Affecting Older People. Drugs Aging. 2022;39(10):829-840.
Doherty AS, Lund LC, Moriarty F, et al. Prescribing Cascades Among Older Community-Dwelling Adults: Application of Prescription Sequence Symmetry Analysis to a National Database in Ireland. Ann Fam Med. 2025;23(4):315-324.

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.