<format type="yaml">{report_id: string, report_date: date, patient_details: {patient_id: string, age_at_reaction: number optional, gender: string, relevant_history: list[string]}, suspected_drugs: list[{drug_name: string, drug_class: string optional, dosage: string, route_of_administration: string, start_date: date, end_date: date optional, indication_for_use: string}], adverse_reactions: list[{symptom_name: string, onset_date: date, severity: string, outcome: string, intervention_required: boolean, intervention_details: string optional}], causality_assessment: {naranjo_score: number optional, assessment_conclusion: string, dechallenge_rechallenge: string}, reporting_facility: string, reporter_type: string, notes: string optional}</format> <data>PHARMACOVIGILANCE CASE REPORT - CONFIDENTIAL
Report Identifier: ADR-2025-388
Date of Submission: 2025-05-11

This report was submitted by a Pharmacist from Wood, Murphy and Sanchez Medical Center concerning patient ANON-PX-8005. The subject is a 33-year-old male with a significant medical history including hypertension, seasonal allergies, asthma. The facility's standard operating procedure for ADR reporting was followed, and all patient data has been anonymized. The patient chart was reviewed for comorbidities. 

Current medication review revealed the following suspected agent(s): Gabapentin (Anticonvulsant) administered via the Subcutaneous route at a dosage of 269mg, initiated on 2025-03-09 for Neuropathic pain with the course ongoing; Metformin (Biguanide) administered via the Intravenous route at a dosage of 56mg, initiated on 2025-03-09 for Type 2 diabetes with the course ongoing.

On approximately 2025-04-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Angioedema, Headache, Hepatotoxicity, Somnolence. The Dizziness was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed recognize and advised administration. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed serve and advised lead. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Eight five stuff eat what lawyer. Question religious prepare.</data>
report_id: ADR-2025-388
report_date: '2025-05-11'
patient_details:
  patient_id: ANON-PX-8005
  gender: Male
  relevant_history:
  - hypertension
  - seasonal allergies
  - asthma
  age_at_reaction: 33
suspected_drugs:
- drug_name: Gabapentin
  dosage: 269mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-09'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
- drug_name: Metformin
  dosage: 56mg
  route_of_administration: Intravenous
  start_date: '2025-03-09'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-04-06'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-04-06'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-04-06'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed recognize and advised administration.
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-06'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed serve and advised lead.
- symptom_name: Somnolence
  onset_date: '2025-04-06'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Wood, Murphy and Sanchez Medical Center
reporter_type: Pharmacist
notes: Eight five stuff eat what lawyer. Question religious prepare.
