The prescribing cascade

A ‘prescribing cascade’ arises when an adverse drug event occurs that is misinterpreted as a new medical condition, and a subsequent medication is prescribed.²² This may contribute to additional adverse effects, for instance, initiating a diuretic for oedema associated with a dihydropyridine calcium channel blocker may put the person at risk of fluid depletion. Another example is the prescribing of a proton pump inhibitor (PPI) due to gastro-intestinal (GI) irritation caused by prescribing of non-steroidal anti-inflammatory drug (NSAID).