A 75-year-old man with symptomatic benign prostatic hyperplasia (BPH) should not be prescribed:

Amitriptyline is an antidepressant that has anticholinergic properties, which can lead to urinary retention. This is particularly concerning in older adults with benign prostatic hyperplasia (BPH), as the condition is characterized by an enlarged prostate that can already obstruct urinary flow. The use of medications with anticholinergic effects can exacerbate these symptoms, making it difficult for the patient to void effectively. Thus, prescribing amitriptyline to a patient with symptomatic BPH can lead to worsened urinary symptoms and hinder the management of the condition.

In contrast, the other medications listed do not have the same risk of exacerbating urinary retention. Enalapril is an ACE inhibitor used primarily for hypertension and heart failure. Atenolol is a beta-blocker, also primarily concerned with cardiovascular issues. Furosemide is a diuretic that helps with fluid management and does not directly worsen BPH symptoms. Consequently, the choice of avoiding amitriptyline is particularly important in the management of a patient with symptomatic BPH due to its potential adverse effects on urinary function.