<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-2025-744
Date of Submission: 2025-01-11

This report was submitted by a Patient from Johnson, Oliver and Jefferson Medical Center concerning patient ANON-PX-5014. The subject is an adult other with a significant medical history including anxiety, seasonal allergies, type 2 diabetes. 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): Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 484mg, initiated on 2024-10-20 for Hypertension and discontinued on 2024-12-24; Levothyroxine administered via the Intramuscular route at a dosage of 226mg, initiated on 2024-10-20 for Hypothyroidism and discontinued on 2024-12-24.

On approximately 2024-10-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Pruritus, Nausea, Hepatotoxicity, Dizziness. The Stevens-Johnson syndrome was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed coach and advised woman. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed since and advised person. The current patient status regarding this symptom is 'Not Recovered'. The Dizziness was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed improve and advised authority. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-744
report_date: '2025-01-11'
patient_details:
  patient_id: ANON-PX-5014
  gender: Other
  relevant_history:
  - anxiety
  - seasonal allergies
  - type 2 diabetes
suspected_drugs:
- drug_name: Lisinopril
  dosage: 484mg
  route_of_administration: Intravenous
  start_date: '2024-10-20'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-12-24'
- drug_name: Levothyroxine
  dosage: 226mg
  route_of_administration: Intramuscular
  start_date: '2024-10-20'
  indication_for_use: Hypothyroidism
  end_date: '2024-12-24'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-27'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2024-10-27'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2024-10-27'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed coach and advised woman.
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-27'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed since and advised person.
- symptom_name: Dizziness
  onset_date: '2024-10-27'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed improve and advised authority.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 10
reporting_facility: Johnson, Oliver and Jefferson Medical Center
reporter_type: Patient
