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An 85 year-old woman with a history of hypertension, atrial fibrillation, chronic kidney disease (stage 1), and Parkinson’s disease is admitted to the hospital with fever and confusion. She is found to have a urinary tract infection and is receiving intravenous ceftriaxone. On hospital day 1, she complains of an exacerbation of back pain, rating her pain a 10/10, for which she is started on morphine. On day 2 of her hospitalization, she becomes restless and agitated and is given 2 doses of lorazepam. After sleeping 12 hours she awakens and is oriented to herself only, difficult to redirect, and extremely agitated, constantly attempting to pull on her IV lines and get out of bed. Her other medications include metoprolol, amiodarone, aspirin, and carbidopa-levodopa.


Which of the following medication changes may help with her agitation?

  1. Switch lorazepam to quetiapine
  2. Switch lorazepam to diazepam
  3. Switch lorazepam to haloperidol
  4. Switch morphine to acetaminophen

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