Final answer:
Tacrine is contraindicated for the elderly woman with Alzheimer's on hemodialysis due to its hepatotoxic potential.
Step-by-step explanation:
The 85-year-old woman with a history of Alzheimer's disease and on hemodialysis who is referred for evaluation should avoid the medication Tacrine (option D). Tacrine is a cholinesterase inhibitor, similar to the other drugs listed, but it has been associated with hepatotoxicity and is no longer commonly used due to its side effect profile which includes the potential for liver damage. Given the patient's age and the fact that she is receiving hemodialysis, drugs with a high potential for toxicity should generally be avoided. Rivastigmine, Galantamine, Donepezil, and Memantine are medications used to manage the symptoms of Alzheimer's disease by working to increase acetylcholine neurotransmission or modulating the glutamatergic system, but they do not cure the disease. Their side effects are generally more tolerable compared to Tacrine, making them more appropriate for use in elderly patients, particularly those on hemodialysis.