<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-2025-977
Date of Submission: 2025-01-28

This report was submitted by a Patient from Gould-Dunn Medical Center concerning patient ANON-PX-4281. The subject is a 69-year-old female with a significant medical history including type 2 diabetes, osteoarthritis, chronic kidney disease, hypertension. 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): Ibuprofen (NSAID) administered via the Intramuscular route at a dosage of 92mg, initiated on 2025-01-02 for Pain and inflammation and discontinued on 2025-01-12; Sertraline (SSRI) administered via the Intravenous route at a dosage of 298mg, initiated on 2025-01-02 for Major depressive disorder and discontinued on 2025-01-12.

On approximately 2025-01-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Anaphylaxis, Somnolence. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed human and advised door. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

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

Reporter's Narrative Summary: Probably dinner court yeah particularly. Garden myself benefit such situation current hold.</data>
report_id: ADR-2025-977
report_date: '2025-01-28'
patient_details:
  patient_id: ANON-PX-4281
  gender: Female
  relevant_history:
  - type 2 diabetes
  - osteoarthritis
  - chronic kidney disease
  - hypertension
  age_at_reaction: 69
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 92mg
  route_of_administration: Intramuscular
  start_date: '2025-01-02'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-01-12'
- drug_name: Sertraline
  dosage: 298mg
  route_of_administration: Intravenous
  start_date: '2025-01-02'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-01-12'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-01-06'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-01-06'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed human and advised door.
- symptom_name: Somnolence
  onset_date: '2025-01-06'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Gould-Dunn Medical Center
reporter_type: Patient
notes: Probably dinner court yeah particularly. Garden myself benefit such situation
  current hold.
