Aiko Bouchard

90 · female · Hypertension, Reflux / indigestion, Osteoarthritis pain

Medicines

Likely cascade links

Could be avoidable

Anticholinergic burden

Drugs toward falls

Dangerous combos

Root drug · likely · score 0.58

Diclofenac → 2 downstream

Diclofenac

NSAID

Lisinopril

ACE inhibitor

Dextromethorphan

Cough suppressant

Root drug · likely · score 0.99

Lisinopril

ACE inhibitor

Dextromethorphan

Cough suppressant

Root drug · possible · score 0.42

Pantoprazole

Proton pump inhibitor

Loperamide

Antidiarrhoeal

Why Domino thinks so

Diclofenac started Jun 20, 2023 · Lisinopril started Oct 9, 2024

0.37

possible

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

Timing×0.35Lisinopril started 16 months later, long after hypertension usually appears.

Other reasons×1.25Lisinopril 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, 16 ms