Omar Pelletier

95 · male · Hypertension

Prepared by Domino · Oct 1, 2026

Summary

1 likely prescribing cascade link. If Hydrochlorothiazide were reviewed, up to 1 downstream medicine might no longer be needed (2 → 0).

Question 1

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

Hydrochlorothiazide (Apr 25, 2025) → gout or high uric acid → Allopurinol (Jul 19, 2025) · likely 0.99 · study

If reviewed: Allopurinol; medicines 2 → 0; anticholinergic burden 0 → 0; fall-risk drugs 1 → 0.

Medicines

Medicine	Started	Charted for	Domino
Hydrochlorothiazide as prescribed Dr. A. Patel (family doctor)	Apr 25, 2025	Hypertension	Root of a cascade Beers-listed
Allopurinol as prescribed Dr. R. Ahmed (walk-in clinic)	Jul 19, 2025	Gout / hyperuricaemia	Possibly treating a side effect

Evidence

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

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.