5th March 2024

An 85-year-old patient is on the acute cardiac ward following repeated episodes of syncope.

An 85-year-old patient is on the acute cardiac ward following repeated episodes of syncope. He has been settled on the ward for over a week and has not experienced a syncopal episode for over 4 days. However, he is now complaining of dizziness when he stands up and following sitting/standing blood pressure measurements a diagnosis of postural hypotension is made. The consultant tasks the F1 on the ward to look over his regular prescriptions to see if there are any medications which could be increasing his postural drop. He has a past medical history of hypertension, type 2 diabetes, and a previous Transient ischaemic attack.

Select the single most likely drug to be contributing to this patient’s symptoms.