Review Question - QID 213544

A 55-year-old woman presents to the emergency department with chest pain, shortness of breath, and weakness. She has no known past medical history and generally refuses to see a physician for health issues. Review of systems is notable for chronic, severe gastroesophageal reflux disease and chronic diarrhea. Her temperature is 98.3°F (36.8°C), blood pressure is 177/105 mmHg, pulse is 88/min, respirations are 14/min, and oxygen saturation is 97% on room air. Laboratory values are ordered as seen below.

Hemoglobin: 10 g/dL
Hematocrit: 30%
Leukocyte count: 4,500/mm^3 with normal differential
Platelet count: 192,400/mm^3

Serum:
Na+: 139 mEq/L
Cl-: 101 mEq/L
K+: 6.3 mEq/L
BUN: 65 mg/dL
Glucose: 99 mg/dL
Creatinine: 3.1 mg/dL

Notably, the patient requires nursing to help her with most tasks such as putting on her gown and manipulating a cup of water given poor mobility of her hands. She also has recurrent episodes of severe hand pain, which self resolve. The patient is given calcium, insulin, and dextrose and started on dialysis. Which of the following is the most appropriate medical therapy for this patient?