<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-2024-612
Date of Submission: 2024-12-15

This report was submitted by a Nurse from Hernandez-Kelly Medical Center concerning patient ANON-PX-8434. The subject is a 66-year-old other with a significant medical history including osteoarthritis, migraines, 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): Ibuprofen (NSAID) administered via the Oral route at a dosage of 201mg, initiated on 2024-10-08 for Pain and inflammation and discontinued on 2024-12-14; Levothyroxine (Thyroid hormone) administered via the Intramuscular route at a dosage of 73mg, initiated on 2024-10-08 for Hypothyroidism and discontinued on 2024-12-14.

On approximately 2024-12-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Vomiting, Maculopapular Rash. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed oil and advised realize. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 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. 

Reporter's Narrative Summary: His southern need by everyone song. Activity news not become somebody dinner with.</data>
report_id: ADR-2024-612
report_date: '2024-12-15'
patient_details:
  patient_id: ANON-PX-8434
  gender: Other
  relevant_history:
  - osteoarthritis
  - migraines
  - hypertension
  age_at_reaction: 66
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 201mg
  route_of_administration: Oral
  start_date: '2024-10-08'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-12-14'
- drug_name: Levothyroxine
  dosage: 73mg
  route_of_administration: Intramuscular
  start_date: '2024-10-08'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-12-14'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-12-04'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed oil and advised realize.
- symptom_name: Vomiting
  onset_date: '2024-12-04'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-12-04'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 10
reporting_facility: Hernandez-Kelly Medical Center
reporter_type: Nurse
notes: His southern need by everyone song. Activity news not become somebody dinner
  with.
