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April 17, 2024

A 78-year old woman comes to the office with her husband, who notes that she has had an increase in aggressive behavior,

A 78-year old woman comes to the office with her husband, who notes that she has had an increase in aggressive behavior, delusions, and confusion over the past 2 weeks. Additionally, she is complaining her mouth is dry. She strains to pass hard stools. History is significant for hypertension, depression, osteoarthritis, probable Alzheimer’s disease, and urinary incontinence. Her MMSE score 6 months ago was 16/30. Medications include Acetaminophen 500 mg four times daily, Donepezil 5 mg daily, HCTZ 25 mg daily, Lisinopril 10 mg daily, Oxybutynin 5mg twice daily (increased one month ago from 2.5 mg twice daily), and Citalopram 20 mg daily (increased two months ago from 10 mg). Urinalysis performed today is normal. Which of the following is the MOST appropriate next intervention? Reduce Citalopram Increase the dosage of Donepezil Discontinue Oxybutynin Start Lorazepam

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