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: no known allergies / adverse drug reactions attending: chief complaint: overdose major surgical or invasive procedure: egd history of present illness: 66 yo m with history of bipolar disorder, asthma and htn who presents after an overdose. ex-wife reports that her last contact with him was a text message at ~8:00 pm the day prior to presentation and that his daughters spoke to him over the phone some time in the earlier that evening. over the course of yesterday they tried to contact him without success and at ~6:30 pm they went to his aparment to check on him and found him face down and mumbling. he had multiple empty pill bottles around him with lables: lamotrigine 150mg 2 bottles filled and both with #180 pills, lisinopril 10mg filled #180, clonazepam 0.5mg 2 bottles filled and both with #135. reportedly also had some bottles toilet bowl cleaner and drano that were half empty around. they asked him if he had tried to hurt himself by taking the meds and he said yes. he was initially taken to where he had a gcs 15, vomited x2 and was intubated for airway protection during which no burns were seen. an ng lavage was done and he was treated with charcoal and sorbital. ct head and cxr were normal and he was transferred to . of note, he has no history of prior suicide attempts. . in the ed, intial labs were remarkable for wbc 14.2, cr 1.7, acetaminophen level of 8 and lactate of 2.9. toxicology was consulted and recommended following ekg's for qrs prolongation (>120 ms). if so, treating with bicarb. ekg was done with qrs of 112 so no bicarb was given. a cxr revealed small bilateral pleural effusions but otherwise no acute process. he received propofol for sedation and 4l ns. vs prior to transfer bp 119/69 hr 67 sat 100% on cmv 100% fio2, tv 580 ml and peep 5. . in the micu, he was primarily given supportive care. the patient's primary manifestation of his injestions was respiratory depression. he was seen by social work and psychiatry, the latter who concluded that he will need inpatient psychiatry. he cannot leave ama. he has a 1:1 sitter. he had some rhabdomyolysis was given fluid repletion. he was seen by gi, who performed a egd that showed erythema in esophagus signs of injury with no further follow up needed. he was extubated later the day of his admission. after extubation, he spiked a fever to 101.0 with a high suspicion for pneumonia and was started on a course of vancomycin and cefepime x 8 days. he is currently on day 2 of his course. he has been kept npo due to risk of aspiration. he is visited daily by his children and his ex-wife. also began to have symptoms of withdrawal, including tremors seen in his upper extremities and his mouth. he was started on valium prn withdrawal symptoms. . on transfer, he is somnolent but responsive. he is responsive to his daughter and ex-wife but is hesitant around doctors. s abdominal pain. he is unable to speak because of pain due to the injury to his mouth from the injestion. his ex-wife also reports that he has been complaining of chest pain recently as well. . ros: as per hpi past medical history: bipolar disorder diagnosed at age 60 htn asthma social history: lives at home with wife. 2 daughters. family denies tobacco, etoh or drug use. family history: non-contributory physical exam: on admission: bp 119/69 hr 67 sat 100% on cmv 100% fio2, tv 580 ml and peep 5 general: intubated, sedated. heent: sclera anicteric, perrl. neck: supple, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi 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 skin: maculopapular, erythematous rash over neck, trunk and both forearms. . on discharge: general: alert, nad heent: nc/at, sclera anicteric, perrl, mmm, oropharynx clear neck: supple, no lad, thyroid wnl lungs: ctab cv: rrr, no m/r/g abdomen: soft, nt/nd, +bs ext: 2+ pulses, no clubbing, cyanosis or edema skin: no rashes neuro: a+o x 3. no focal deficits. pertinent results: on admission: 12:00am blood wbc-14.2* rbc-4.69 hgb-14.6 hct-40.4 mcv-86 mch-31.2 mchc-36.2* rdw-13.1 plt ct-208 12:00am blood pt-13.8* ptt-29.0 inr(pt)-1.2* 03:45am blood glucose-130* urean-26* creat-1.6* na-143 k-4.3 cl-113* hco3-17* angap-17 12:00am blood alt-44* ast-163* ld(ldh)-904* ck(cpk)-* alkphos-64 totbili-0.7 12:00am blood asa-neg ethanol-neg acetmnp-8* bnzodzp-neg barbitr-neg tricycl-neg 12:03am blood po2-73* pco2-35 ph-7.39 caltco2-22 base xs--2 comment-green top, 12:03am blood glucose-134* lactate-2.9* na-141 k-4.7 cl-107 on discharge: studies: ecg on admission- rate pr qrs qt/qtc p qrs t 66 200 112 436/446 47 5 35 cxr on admission- mpression: appropriate position of lines and tubes. small left pleural effusion with associated atelectasis. egd report - erythema in the whole esophagus friability, erythema and congestion in the whole stomach - grade 1 injury from lye injestion. otherwise normal egd to third part of the duodenum brief hospital course: mr. is a 66 year old man with a history of bipolar disorder who was found down with multiple empty pill bottles and toilet cleaner around him. he initially presented to osh with lethargy and was intubated for airway protection. transferred to . #. overdose/ingestion: the patient was found down by family with multiple pill bottles (lamotrigine 150mg 2 bottles filled and both with #180 pills, lisinopril 10mg filled #180, clonazepam 0.5mg 2 bottles filled and both with #135) and toilet bowl cleaner/drano that were half empty around. taken to an osh where he became lethargic and required intubation for ams. tranferred to micu intubated. in the micu the patient was able to maintain his pressures although still with ams. egd performed showing only minimal caustic injury and they signed off on him. serial ekgs performed without significant qrs widening. in pm of day of transfer, the patient was on minimal vent setting and was able to be extubated. since extubation, the patient has been oxygenating well. on he was transitioned to nc and was stable for transition to the floor. on the floor, he had no further issues related to his overdose. #. pneumonia: after extubation in the micu, the patient spiked a fever and was found to have consolidations on cxr concerning for aspiration pna. he was started on a course of vancomycin and cefepime for an 8 day course. on hospital day 4, he was switched to levoquin from the broader course. after he was changed to haldol for his agitation, his qtc was followed on ekg and was found to be wnl. due to concern after his trigger, the levoquin was switched to ceftriaxone q12h to complete the four day course. the patient had a cough but otherwise remained afebrile throughout his stay. his ceftriaxone was discontinued on day 8 of his antibiotic course. he was afebrile one day after discontinuing his antibiotic course and has not been symptomatic for several days. # atrial fibrillation: the patient triggered for hr to 200s with apparent svt while on the floor, hospital day 4. he was administered adenosine 6, 6, 12 and 18 during the course of the trigger with mom relief of the aberrant rhythm. he was also given 5.0mg lopressor total. cardiology was consulted, who believed it to be afib with rvr. shortly after the lopressor doses, he converted to sinus with hr 90 and was stable for the rest of the day. he was started on metoprolol 25mg qid and continued on metorpolol 50mg . he was followed on tele for the duration of his stay and did not have any more events. he remained in sinus with rates between 60-90bpm off of telemetry. he has not had another episode of atrial fibrillation in-house. #. renal failure: the patient's baseline cr is unknown, 1.7 on admission. ck meausred in the ed was highly elevated and there was immediate concern for rhabdo. the patient was tx'ed with ivf and over the subsequent hospital days his cr and ck began to trend downwards. cause of rhabdo is unknown although may be related to lamotrigine overdose. his ck resolved progressively once transferred to the floor and his cr resolved to 1.0 by his second day on the floor. #. elevated lft's: ast 163, alt 44 suggestive of alcohol induced liver injury (although family denies alcohol use) and inr 1.2. tylenol level 17 at osh and 8 making tylenol overdose also a possbility as is transient hypoperfusion due to low bp induced by lisinopril overdose. liver dysfunction will affect clearance of medications. nac not believed to be indicated at this time and hepatitis serologies negative. his lfts were followed on the floor and were found to be stable. #. delirium: the patient takes standing klonipin at home and was thought in the icu to be withdrawing from the benzo. during his stay in the micu, the patient began to become agitated with facial tremors, htn and anxiety. resolved with ativan. he was placed on ativan prn for the symptoms and on the floor was put on to valium. psychiatry was consulted, and they believed that he was in fact experiencing delirium from the high doses of valium that he received while on . he was followed by psych but was not considered to be medically cleared for dispo to a psych facility until his delirium resolved. due to his delirium, he was an aspiration risk and was npo for one day before he was advanced to softs. for agitation, he was prescribed haldol 2.5mg qhs as a standing dose along with haldol q4h prn agitation. his haldol dosage was monitored because of qtc elevation after he got a large prn dosage of haldol. his qtc resolved to 455 on ekg following a reduction in his haldol dosage. his delirium resolved on hospital day 7 and haldol was no longer required and was discontinued. he has not had any recurrent delirium and he was advanced to a full diet 2 days prior to discharge. physical therapy has seen him and believe he is now stable to ambulate on his own with a walker. #. suicide attempt: above likely in the setting of suicide attempt. psychiatry consulted on and continued to follow him on the floor. his psychotropic medications were held and he was placed with a 1:1 sitter wihle in the micu and on the floor. he has been stable with his sitters. #. asthma: the patient has asthma and his asthma medication was held while he was delirius. with resolution of his delirium, he was placed on his home asthma medications to good effect. this issue has been stable for his hospitalization. . -------------------- transitions of care: - pt is on an asthma regimen that is close to his baseline. he should follow up with his pcp after his final discharge to solidfy his asthma regimen. - he is medically stable for discharge to his inpatient psychiatric facility in terms of his hypertension, po intake, asthma and cardiac funciton. medications on admission: lamotrigine 150 mg clonazepam 0.75 mg qhs lisinopril 10 mg daily serevent 50mcg inh daily flovent 110mcg inh daily discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for dyspnea/wheezing. disp:*1 inhaler* refills:*0* 2. fluticasone 110 mcg/actuation aerosol sig: one (1) puff inhalation (2 times a day). disp:*1 inhaler* refills:*0* 3. salmeterol 50 mcg/dose disk with device sig: one (1) puff inhalation q12h (every 12 hours). disp:*1 inhaler* refills:*0* 4. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* discharge disposition: extended care discharge diagnosis: primary diagnosis: overdose secondary diagnosis: hypertension atrial fibrillation delirium discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital because you overdosed and ingested a lot of caustic materials at your home. you first went to the intensive care unit, where you were put on breathing support and blood tests were done. gastroenterology physicians followed you and viewed your upper digestive tract and those results were reassuring for your healing. the toxocologists followed you as well and determined after two days that there were no lingering effects of your overdose. you were removed from the breathing support and started on antibiotics after you spiked a fever that was likely from pneumonia. on your second day, you were stable enough to go to the regular hospital floor. there, you were continued on your antibiotics and seen by a psychiatrist. you were medically stabilized so that you could go on to your psychiatry facility to be treated. we made sure that your blood pressure was under control, had you see the physical therapists, and followed an irregular heart rate you had called atrial fibrillation. to help prevent blood clots and for heart health, we started you on aspirin. you were delirius for a few days but that cleared a few days prior to your discharge. the following changes or additions were made in your medications: lisinopril 10mg is now lisinopril 20mg by mouth daily aspirin 81mg by mouth daily pantoprazole 40mg by mouth daily we discontinued the following of your psych meds: lamotrigine 150mg by mouth twice daily clonazepam 0.75mg by mouth at bedtime we were unsure about your asthma regimen and were unable to get in touch with your current primary care physician. , you were started in-house on the following regimen: serevent 50mcg inhaled 1 puff twice daily flovent 110mcg inhaled 1 puff twice daily albuterol inhaled 1 puff every six hours as needed for shortness of breath and wheezing please get in touch with your current primary care physician to work though your asthma regimen. followup instructions: please follow up with your primary care physician weeks of your discharge to follow up on your asthma medications. md procedure: other endoscopy of small intestine diagnoses: unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation asthma, unspecified type, unspecified pneumonitis due to inhalation of food or vomitus bipolar disorder, unspecified delirium due to conditions classified elsewhere rhabdomyolysis alcohol withdrawal 

Answer: The patient is high likely exposed to