<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-2025-622
Date of Submission: 2025-04-24

This report was submitted by a Pharmacist from Peters-Hansen Medical Center concerning patient ANON-PX-3537. The subject is a 90-year-old male with a significant medical history including seasonal allergies, 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): Lisinopril (ACE inhibitor) administered via the Topical route at a dosage of 281mg, initiated on 2025-03-22 for Hypertension and discontinued on 2025-04-06; Omeprazole (Proton-pump inhibitor) administered via the Subcutaneous route at a dosage of 233mg, initiated on 2025-03-22 for Gastroesophageal reflux disease and discontinued on 2025-04-06.

On approximately 2025-03-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Headache, Maculopapular Rash, Angioedema. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Headache was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed I and advised crime. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Angioedema was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 was calculated, 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: Clearly nor church suddenly. Themselves manager local option team my deep. Ahead himself open keep gas most.</data>
report_id: ADR-2025-622
report_date: '2025-04-24'
patient_details:
  patient_id: ANON-PX-3537
  gender: Male
  relevant_history:
  - seasonal allergies
  - hypertension
  age_at_reaction: 90
suspected_drugs:
- drug_name: Lisinopril
  dosage: 281mg
  route_of_administration: Topical
  start_date: '2025-03-22'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-04-06'
- drug_name: Omeprazole
  dosage: 233mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-22'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-04-06'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-03-29'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-03-29'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed I and advised crime.
- symptom_name: Maculopapular Rash
  onset_date: '2025-03-29'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-03-29'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Peters-Hansen Medical Center
reporter_type: Pharmacist
notes: Clearly nor church suddenly. Themselves manager local option team my deep.
  Ahead himself open keep gas most.
