Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: chantix / wellbutrin / citalopram attending: chief complaint: multi-drug overdose major surgical or invasive procedure: extubation history of present illness: 27 f with a history of depression who was transferred to after she was evaluated and intubated at for multi-drug overdose. according to her , she was recently going through stressful times in her personal life (she had recently ended a relationship with a partner who lives in , and underwent elective abortion approximately two weeks ago). however, she had not made any statements about being depressed or expressed any suicidal ideation to family. her mother notes she "had a bad day" because of a conversation with her former partner, but she seemed more or less her normal self when she was with her family at her son's preschool graduation yesterday evening. after that event, she went home with her son, but a few hours later called her father and asked him to pick up her son and take him for the night, because she needed to rest. . per report, she later texted a friend with statements such as "i want to feel numb" and "i just need to sleep." her friend was concerned and came to her house to check on her. further details are somewhat unclear, but it seems that the friend found her with pill bottles, seeming agitated and not herself. he called her and ems, who brought her to the . there, she was given activated charcoal, some of which she vomited. nursing notes describe "screaming" and agitation. per verbal report, there was transient hypoxia though low saturation is not documented in chart. she was intubated for altered mental status and combative behavior, but it was a difficult intubation requiring multiple attempts and she received ativan and paralytics. total meds at osh include zofran 4mg iv, ativan 1 mg iv x 2 and 2 mg iv x2, etomidate 10 mg iv push x 3 doses, anectine 120 mg iv push, versed 4mg iv, charcoal 50 g po, and 1l of ns prior to transfer. . in the ed, initial vs were: t 98.8, hr 90, bp 110/66, rr 12 (set), fio2 50%. blood gas showed 7.31/43/142/23. tox screen was positive for benzodiazepines, but otherwise negative (including negative tca). patient was given fentanyl and versed for sedation and admitted to icu for further care. . on the floor, she was not responsive to commands and not opening eyes (off fentanyl, on 2 of versed gtt at that time). her were both with her in the room, tearful and obviously upset. . review of sytems: could not be obtained. per family, no recent medical complaints. past medical history: - depression (has been medication refractory, no current counseling) - anxiety - tonsils and adenoids removed, childhood - c-section 5 years ago - abortion (? surgical) two weeks ago (done in , mother does not know the name of the facility) social history: lives in with her five-year-old son. are nearby. she smokes cigarettes but does not drink alcohol regularly per family. no current illicit drug use per mother, but did use marijuana as an adolescent, which made her "paranoid." family history: has a maternal aunt who was possibly bipolar, but no clear family history of suicide attempts or hospitalization for mental health disorders. maternal grandmother died age 67 of complications related to blood clots; also had chf. paternal grandfather and maternal great aunt had diabetes. maternal aunt passed away of "internal bleeding." , , and two brothers and one sister are alive and healthy. physical exam: physical exam on admission: vitals: t: 97.2 bp: 116/68 p: 97 r: 20 o2: 98% on 50% fio2 general: intubated, sedated, not opening eyes or following commands heent: sclera anicteric, slightly dry mucous membranes with activated charcoal around lips, pupils 3 mm, reactive neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. 2 pivs in place. tattoo with "" (son's name) on right foot. pertinent results: labs on admission: 04:30am blood wbc-16.5* rbc-4.35 hgb-13.3 hct-39.1 mcv-90 mch-30.6 mchc-34.1 rdw-13.2 plt ct-352 04:30am blood neuts-81.7* lymphs-14.2* monos-3.5 eos-0.4 baso-0.2 04:30am blood pt-13.1 ptt-21.4* inr(pt)-1.1 04:30am blood fibrino-334 04:30am blood glucose-96 urean-7 creat-0.7 na-140 k-4.4 cl-106 hco3-21* angap-17 04:30am blood alt-13 ast-22 ld(ldh)-196 alkphos-52 totbili-0.5 04:30am blood lipase-31 04:30am blood albumin-4.4 calcium-8.7 phos-3.7 mg-2.0 10:21am blood acetone-negative osmolal-287 04:30am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 04:35am blood lactate-2.2* 04:30am urine color-yellow appear-hazy sp -1.006 04:30am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 08:32am urine rbc-15* wbc-1 bacteri-none yeast-none epi-3 08:32am urine amorphx-many 08:32am urine mucous-few 04:30am urine hours-random urean-132 creat-89 na-20 k-25 cl-13 calcium-5.4 phos-49.2 04:30am urine ucg-negative osmolal-188 04:30am urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg labs on discharge: microbiology: - blood cultures x2: - urine culture: negative - sputum: gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): multiple organisms consistent with oropharyngeal flora. respiratory culture (final ): moderate growth commensal respiratory flora. beta streptococci, not group a. moderate growth. imaging: - cxr: et tube tip lies approximately 2.9 cm above the carina. nasogastric tube passes below the diaphragm with side port in the gastric fundus and tip within the body of the stomach. bilateral low lung volumes are noted, with crowding of bronchovascular markings; however, no focal consolidation, pleural effusion or pneumothorax is noted. the study and the report were reviewed by the staff radiologist. - cta others: - ekg: normal sinus rhythm with short p-r interval. no previous tracing available for comparison. intervals axes rate pr qrs qt/qtc p qrs t 91 100 92 372/426 62 81 37 brief hospital course: 27 f with a history of depression/anxiety who was transferred from for multi-drug overdose requiring intubation. # multi-drug overdose. upon arrival to the icu, it was unclear how much medications patient took, since she was found to be altered by several empty pill bottles. prior to the incidence, patient expressed the wish to "feel numb" to her friend, but without clear ideation. she has 4 pill bottles with her, including empty 30-pill bottles of effexor xr, paroxetine, and amitryptyline and 17/30 pills remaining in bottle of doxepin. of these, the most concerning ingestion is the tca given risks of seizure and arrhythmia. low r-wave in avr (< 3mm) and short qrs (< 100) are reassuring as these are less commonly associated with complications. initially, she was somewhat hypertonic, which was thought possibly paroxetine overdose or from the paralytics from osh. she was monitored closely for tca/ssri overdose with serial ekg looking for prolonged qtc and for seratonin syndrome. patient did not develop either while in the intensive care unit. she was given charcoal 1x while in the icu in addition to charcoal 1x in the osh. she was weaned off sedation and subsequently extubated without complication. patient later admitted to ingesting all the medications that were found by her side on the day of the incidence despite the fact that her toxin screen was negative except for benzodiazepine. psychiatry and sw were consulted. apparently, she did not realize the gravity of her actions and was uncertain what triggerred her od. she was placed on 1:1 sitter and then later sectioned 12. psychiatry inpatient placement # altered mental status, most likely medication overdose. patient was intubated at osh for altered mental status and combativeness. per osh records, she was 99-100% on 15l o2 prior to intubation; no documented hypoxia. the intubation was reportedly difficult (2 attempts, lma, ultimately intubated with 6.5 over bougie). she has normal breath sounds and tube appears properly placed on cxr. she was weaned off sedation and was extubated successfully on . # aspiration pneumonia. had leukocytosis on admission. urine culture was negative and blood culture was also unrevealing. intially thought to be from traumatic intubation, but cxr did show rml consolidation. she was initially placed on unasyn on which was subsequently switched to augmentin on . the plan is for her to complete a total of 7 day course to be completed on am. # depression. history somewhat unclear but per has never been hospitalized. recent stressors with regard to her failed relationship and abortion may have been precipitating factors for this episode. psychiatry and sw were consulted. she was placed on 1:1 given her medication od and later was sectioned 12 given her poor insight and depression. the plan is for her to get inpatient psychiatry treatment for her depression # recent abortion. presumed surgical abortion done in (location of facility unknown to mother). no evidence of vaginal bleeding on initial exam. urine hcg negative at osh. - continue to monitor - contact: emergency contacts are and (cells: ; ) transitional issues: inpatient psychiatry augmentin x total 7 days to be completed for aspiration pna needs follow-up cxr in weeks to see resolution of pneumonia outpatient follow up with pcp medications on admission: pharmacy: confirmed with family pharmacy . meds prescribed by pcp . except as noted. bottles for amitryptiline, paroxetine, doxepin, and effexor were with patient with fill dates and pill counts as noted. - prenatal vitamin (dr. (obgyn), ) - amitryptyline 10 mg po daily (filled , 0/30 pills in bottle) - paroxetine 10 mg po daily (dr. ; filled ; 0/30 pills in bottle) - doxepin 25 mg po daily (filled ; 17/30 pills in bottle) - effexor xr 37.5 mg po daily (filled ; 0/30 pills in bottle) - lorazepam 1 mg po tid prn anxiety (filled ; bottle not with patient) discharge medications: 1. amoxicillin-pot clavulanate 875-125 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days: from - . discharge disposition: extended care facility: health system discharge diagnosis: primary diagnosis: overdose . secondary diagnoses: depression anxiety discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ms. , you were admitted to the because you overdosed on your psychiatric medications. you were initially on the breathing machine but quickly came off of it. we did a ct scan of your chest which showed you have a pneumonia which we treated with antibiotics. please ask your primary care doctor to repeat a chest x-ray in weeks to make sure the pneumonia is completely resolved. we asked the psychiatrists to come see you and they are recommending inpatient psychiatric hospitalization after discharge. . medications: added: - amoxicillin-clavulanic acid 875 mg by mouth every 12 hrs from - changed: none removed: - amitryptyline - proxetine - doxepin - effexor - lorazapam followup instructions: please make an appointment and follow-up with your primary care doctor within 7 days after discharge. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: tobacco use disorder suicide and self-inflicted poisoning by tranquilizers and other psychotropic agents dysthymic disorder acute respiratory failure pneumonitis due to inhalation of food or vomitus drug-induced delirium leukocytosis, unspecified poisoning by other antidepressants poisoning by tricyclic antidepressants 

Answer: The patient is high likely exposed to