<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-2025-870
Date of Submission: 2025-07-28

This report was submitted by a Pharmacist from Nguyen Inc Medical Center concerning patient ANON-PX-3066. The subject is an adult male with a significant medical history including atrial fibrillation, type 2 diabetes, chronic kidney 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): Levothyroxine (Thyroid hormone) administered via the Intramuscular route at a dosage of 228mg, initiated on 2025-07-20 for Hypothyroidism and discontinued on 2025-07-24; Ibuprofen administered via the Intramuscular route at a dosage of 266mg, initiated on 2025-07-20 for Pain and inflammation and discontinued on 2025-07-24.

On approximately 2025-07-24, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Stevens-Johnson syndrome, Hepatotoxicity, Maculopapular Rash. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed issue and advised role. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed huge and advised network. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Moderate 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: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-870
report_date: '2025-07-28'
patient_details:
  patient_id: ANON-PX-3066
  gender: Male
  relevant_history:
  - atrial fibrillation
  - type 2 diabetes
  - chronic kidney disease
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 228mg
  route_of_administration: Intramuscular
  start_date: '2025-07-20'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-07-24'
- drug_name: Ibuprofen
  dosage: 266mg
  route_of_administration: Intramuscular
  start_date: '2025-07-20'
  indication_for_use: Pain and inflammation
  end_date: '2025-07-24'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-07-24'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed issue and advised role.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-07-24'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-07-24'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed huge and advised network.
- symptom_name: Maculopapular Rash
  onset_date: '2025-07-24'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 9
reporting_facility: Nguyen Inc Medical Center
reporter_type: Pharmacist
