<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-2024-302
Date of Submission: 2024-12-22

This report was submitted by a Pharmacist from Wolfe-Sweeney Medical Center concerning patient ANON-PX-7585. The subject is a 41-year-old other with a significant medical history including asthma, coronary artery disease. 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): Warfarin (Anticoagulant) administered via the Oral route at a dosage of 227mg, initiated on 2024-11-01 for Thromboembolism prevention with the course ongoing; Metformin (Biguanide) administered via the Subcutaneous route at a dosage of 349mg, initiated on 2024-11-01 for Type 2 diabetes with the course ongoing.

On approximately 2024-11-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Dizziness, Headache, Angioedema, Hepatotoxicity. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Bag buy billion detail lead possible. Election difficult after need prove maybe nor.</data>
report_id: ADR-2024-302
report_date: '2024-12-22'
patient_details:
  patient_id: ANON-PX-7585
  gender: Other
  relevant_history:
  - asthma
  - coronary artery disease
  age_at_reaction: 41
suspected_drugs:
- drug_name: Warfarin
  dosage: 227mg
  route_of_administration: Oral
  start_date: '2024-11-01'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
- drug_name: Metformin
  dosage: 349mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-01'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-21'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-11-21'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-11-21'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-11-21'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-21'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Wolfe-Sweeney Medical Center
reporter_type: Pharmacist
notes: Bag buy billion detail lead possible. Election difficult after need prove maybe
  nor.
