<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-2025-505
Date of Submission: 2025-04-08

This report was submitted by a Nurse from Hill-Meyer Medical Center concerning patient ANON-PX-6590. The subject is a 52-year-old other with a significant medical history including anxiety, atrial fibrillation. 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 Topical route at a dosage of 423mg, initiated on 2025-02-26 for Pain and inflammation and discontinued on 2025-03-25; Omeprazole (Proton-pump inhibitor) administered via the Subcutaneous route at a dosage of 320mg, initiated on 2025-02-26 for Gastroesophageal reflux disease and discontinued on 2025-03-25.

On approximately 2025-03-20, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Vomiting. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed work and advised professional. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

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report_id: ADR-2025-505
report_date: '2025-04-08'
patient_details:
  patient_id: ANON-PX-6590
  gender: Other
  relevant_history:
  - anxiety
  - atrial fibrillation
  age_at_reaction: 52
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 423mg
  route_of_administration: Topical
  start_date: '2025-02-26'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-03-25'
- drug_name: Omeprazole
  dosage: 320mg
  route_of_administration: Subcutaneous
  start_date: '2025-02-26'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-03-25'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-03-20'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-03-20'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed work and advised professional.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 5
reporting_facility: Hill-Meyer Medical Center
reporter_type: Nurse
notes: Community visit person individual owner how situation example. Remain trip
  remain difference movie above popular particular. Tend wish scene image.
