<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-2025-878
Date of Submission: 2025-03-08

This report was submitted by a Pharmacist from Snyder-Pope Medical Center concerning patient ANON-PX-3331. The subject is a 81-year-old other with a significant medical history including coronary artery disease, osteoarthritis, atrial fibrillation, 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): Lisinopril administered via the Oral route at a dosage of 352mg, initiated on 2025-02-01 for Hypertension with the course ongoing; Atorvastatin administered via the Intramuscular route at a dosage of 213mg, initiated on 2025-02-01 for Hypercholesterolemia with the course ongoing.

On approximately 2025-02-26, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Nausea, Pruritus, Hepatotoxicity. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. 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 ability and advised stop. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-878
report_date: '2025-03-08'
patient_details:
  patient_id: ANON-PX-3331
  gender: Other
  relevant_history:
  - coronary artery disease
  - osteoarthritis
  - atrial fibrillation
  - migraines
  age_at_reaction: 81
suspected_drugs:
- drug_name: Lisinopril
  dosage: 352mg
  route_of_administration: Oral
  start_date: '2025-02-01'
  indication_for_use: Hypertension
- drug_name: Atorvastatin
  dosage: 213mg
  route_of_administration: Intramuscular
  start_date: '2025-02-01'
  indication_for_use: Hypercholesterolemia
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-02-26'
  severity: Severe
  outcome: Fatal
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2025-02-26'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-02-26'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-02-26'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed ability and advised stop.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 5
reporting_facility: Snyder-Pope Medical Center
reporter_type: Pharmacist
