Mei Hughes

92 · female · Heart failure, Anxiety

Pharmacist brief Check a new prescription Export FHIR

Medicines

Likely cascade links

Could be avoidable

Anticholinergic burden

Drugs toward falls

Dangerous combos

Root drug · likely · score 0.99

Furosemide → 2 downstream

Furosemide

Loop diuretic

Trospium

Urinary antimuscarinic

Spironolactone

Potassium-sparing diuretic

Why Domino thinks so

Furosemide → leaking urine, urgency → Trospium

Furosemide started Feb 7, 2023 · Trospium started May 8, 2023

0.99

likely

How often it causes this×0.7Urinary incontinence is common with Furosemide.

Timing×1Trospium started 3 months after Furosemide, inside the usual window for urinary incontinence (1 to 90 days).

Other reasons×1.25Trospium was charted for urinary incontinence.

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

Diuretic → urinary incontinence → bladder medication

Evidence: expert consensus

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

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

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

Checked and set aside

Analysis: 10 FalkorDB queries, run in parallel, 16 ms