<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 30-year-old woman is brought to the emergency department because of a 30-minute history of palpitations, dizziness, and chest discomfort. She has also not urinated since she woke up. She has a history of fibromyalgia treated with clomipramine. There is no family history of serious illness. She does not smoke or drink alcohol. Her temperature is 37C 98.6F, pulse is 120min, and blood pressure is 9060 mm Hg. On mental status examination, she is confused. Examination shows dilated pupils and dry skin. The abdomen is distended, there is tenderness to deep palpation of the lower quadrants with no guarding or rebound and dullness on percussion in the suprapubic region. An ECG shows tachycardia and a QRS complex width of 110 ms. Activated carbon is administered. The patient is intubated. Intravenous fluids and oxygenation are begun. Which of the following is the most appropriate pharmacotherapy for this patient?? A: Glucagon, B: Naloxone, C: Cyproheptadine, D: Sodium bicarbonate, E: Lorazepam,  <response>: This is a medical case about a 30-year-old woman brought to the ER with palpitations, dizziness, chest discomfort, and inability to urinate. She has a history of fibromyalgia treated with clomipramine an antidepressant. On exam she is confused with dilated pupils, dry skin, distended and tender abdomen, and dullness to percussion suggesting urinary retention. ECG shows tachycardia and widened QRS indicating toxicity. The history of clomipramine use along with anticholinergic signs like dilated pupils, dry skin, urinary retention, and altered mental status indicate this patient most likely has clomipramine toxicity. The widened QRS on ECG confirms tricyclic antidepressant toxicity. Of the choices given, the most appropriate treatment is sodium bicarbonate to correct acidosis and stabilize cardiac membranes in tricyclic toxicity. Glucagon could also be considered for inotropic support. Naloxone and lorazepam are incorrect as there are no signs of opioid toxicity. Cyproheptadine is an antihistamine and serotonin antagonist that could potentially help reverse serotonin toxicity but there is no indication of serotonin toxicity here.D: Sodium bicarbonate 