<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-2025-261
Date of Submission: 2025-04-28

This report was submitted by a Pharmacist from Grant and Sons Medical Center concerning patient ANON-PX-4755. The subject is an adult female with a significant medical history including asthma, type 2 diabetes, seasonal allergies, migraines. 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 Topical route at a dosage of 181mg, initiated on 2025-03-25 for Thromboembolism prevention and discontinued on 2025-04-20; Omeprazole administered via the Topical route at a dosage of 310mg, initiated on 2025-03-25 for Gastroesophageal reflux disease and discontinued on 2025-04-20.

On approximately 2025-04-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Pruritus, Somnolence, Hepatotoxicity, Diarrhea. The Headache was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed maintain and advised according. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed movie and advised its. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed data and advised yes. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed since and advised man. 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: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Rise real few room.</data>
report_id: ADR-2025-261
report_date: '2025-04-28'
patient_details:
  patient_id: ANON-PX-4755
  gender: Female
  relevant_history:
  - asthma
  - type 2 diabetes
  - seasonal allergies
  - migraines
suspected_drugs:
- drug_name: Warfarin
  dosage: 181mg
  route_of_administration: Topical
  start_date: '2025-03-25'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-04-20'
- drug_name: Omeprazole
  dosage: 310mg
  route_of_administration: Topical
  start_date: '2025-03-25'
  indication_for_use: Gastroesophageal reflux disease
  end_date: '2025-04-20'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-04-05'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-04-05'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed maintain and advised according.
- symptom_name: Somnolence
  onset_date: '2025-04-05'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed movie and advised its.
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-05'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed data and advised yes.
- symptom_name: Diarrhea
  onset_date: '2025-04-05'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed since and advised man.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Grant and Sons Medical Center
reporter_type: Pharmacist
notes: Rise real few room.
