A 76-year-old man is brought to the office by his daughter due to disruptive behavior. Last night he behaved normally, took his regular
medications, and retired to his bedroom shortly after dinner. When the patient emerged an hour later, he was agitated, irritable, and
confused. When asked what was wrong, he became belligerent and seemed unable to recognize some family members. The
daughter describes similar episodes over the past 3 evenings Although the patient seems calmer and less confused this morning, the
daughter worries that he will have another episode His medical history is significant for essential hypertension, benign prostatic
hyperplasia, mild neurocognitive disorder, insomnia, and a recent increase in anxiety related to stock market losses. Medications
include terazosin and alprazolam A thorough physical examination is unremarkable, with no focal neurologic findings Laboratory
evaluation, including complete blood count and serum electrolytes, is normal. Which of the following is the most appropriate next step
in management of this patient?
- QA Increase dose of alprazolam
- 0 B. Order CT scan of the brain
- 0 C. Prescribe donepezil
- 0 D. Prescribe quetiapine as needed
- 0 E. Taper and discontinue alprazolam
- 0 F Taper and discontinue terazosin
0 voters