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Built on FalkorDB · Graph Hacks 2026

Omar Pelletier · Domino

Patients/p0497

Omar Pelletier

95 · male · Hypertension

Pharmacist brief Check a new prescription Export FHIR

Medicines

Likely cascade links

Could be avoidable

Anticholinergic burden

Drugs toward falls

Dangerous combos

Agent team

gemini:gemini-3.8-flash

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Root drug · likely · score 0.99

Hydrochlorothiazide → 1 downstream

Hydrochlorothiazide

Thiazide diuretic

Allopurinol

Urate-lowering therapy

Why Domino thinks so

Hydrochlorothiazide → gout or high uric acid → Allopurinol

Hydrochlorothiazide started Apr 25, 2025 · Allopurinol started Jul 19, 2025

0.99

likely

How often it causes this×0.7Gout / hyperuricaemia is common with Hydrochlorothiazide.

Timing×1Allopurinol started 12 weeks after Hydrochlorothiazide, inside the usual window for gout / hyperuricaemia (30 to 365 days).

Other reasons×1.25Allopurinol was charted for gout / hyperuricaemia.

Published evidence×1.15Matches a documented cascade backed by a published study.

Thiazide → gout → gout treatment

Evidence: published study

Rochon PA, Gurwitz JH. The prescribing cascade revisited. Lancet. 2017;389(10081):1778-1780.

Question for the pharmacist: Could the gout be from the diuretic raising uric acid? A different antihypertensive may be an option.

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Analysis: 10 FalkorDB queries, run in parallel, 13 ms