<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-2025-667
Date of Submission: 2025-08-09

This report was submitted by a Pharmacist from Jones, Daniel and Dudley Medical Center concerning patient ANON-PX-5208. The subject is an adult female with a significant medical history including seasonal allergies, chronic kidney disease, 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): Amoxicillin (Penicillin antibiotic) administered via the Topical route at a dosage of 8mg, initiated on 2025-05-21 for Bacterial infection with the course ongoing; Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 477mg, initiated on 2025-05-21 for Hypertension with the course ongoing.

On approximately 2025-05-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Angioedema, Pruritus, Dizziness. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed sing and advised next. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed painting and advised answer. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Mild 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. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly 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: Trip many thus capital side. Design west billion share skill door growth.</data>
report_id: ADR-2025-667
report_date: '2025-08-09'
patient_details:
  patient_id: ANON-PX-5208
  gender: Female
  relevant_history:
  - seasonal allergies
  - chronic kidney disease
  - coronary artery disease
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 8mg
  route_of_administration: Topical
  start_date: '2025-05-21'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
- drug_name: Lisinopril
  dosage: 477mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-21'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-05-30'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed sing and advised next.
- symptom_name: Angioedema
  onset_date: '2025-05-30'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-05-30'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed painting and advised answer.
- symptom_name: Dizziness
  onset_date: '2025-05-30'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 9
reporting_facility: Jones, Daniel and Dudley Medical Center
reporter_type: Pharmacist
notes: Trip many thus capital side. Design west billion share skill door growth.
