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Postural hypotension medication — DGM MCQ

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ModerateFallsPostural hypotension medicationDGM

An 82-year-old man reports falls when standing after passing urine at night. He has benign prostatic enlargement and hypertension. Lying blood pressure is 136/74 mmHg and standing blood pressure is 104/60 mmHg. Current medicines include doxazosin, bisoprolol and paracetamol. Which medication should be reviewed?

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Correct answer: C — Doxazosin

Doxazosin can cause postural hypotension and micturition-related falls, particularly in older men. Bisoprolol may contribute to bradycardia but the alpha-blocker is the most direct culprit; paracetamol, colecalciferol and lansoprazole do not explain the postural drop. Medication review is part of falls assessment and should focus on hypotensive agents as well as sedatives.

Reference: NICE NG249; STOPP/START criteria v3