George Reid

83 · male · Urinary incontinence, Hypertension, Osteoarthritis pain, Enlarged prostate (BPH)

Medicines

Likely cascade links

Could be avoidable

Anticholinergic burden

Drugs toward falls

Dangerous combos

Root drug · likely · score 0.87

Diclofenac → 2 downstream

Diclofenac

NSAID

Hydrochlorothiazide

Thiazide diuretic

Allopurinol

Urate-lowering therapy

Why Domino thinks so

Diclofenac started Apr 8, 2023 · Hydrochlorothiazide started Jun 6, 2023

0.99

likely

How often it causes this×0.7Hypertension is common with Diclofenac.

Timing×1Hydrochlorothiazide started 8 weeks after Diclofenac, inside the usual window for hypertension (7 to 90 days).

Other reasons×1.25Hydrochlorothiazide was charted for hypertension.

Published evidence×1.2Matches a documented cascade backed by expert consensus (ThinkCascades).

NSAID → high blood pressure → antihypertensive

Evidence: expert consensus

Not confirmed in the Irish national data (a significant negative association).

Question for the pharmacist: Could the raised blood pressure be from the NSAID? NSAIDs raise blood pressure and blunt most antihypertensives.

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

Checked and set aside

Analysis: 10 FalkorDB queries, run in parallel, 22 ms