<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-2025-193
Date of Submission: 2025-06-16

This report was submitted by a Patient from Acosta and Sons Medical Center concerning patient ANON-PX-7549. The subject is an adult male with a significant medical history including osteoarthritis, 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 Intramuscular route at a dosage of 379mg, initiated on 2025-05-26 for Hypertension and discontinued on 2025-06-13; Metformin administered via the Intramuscular route at a dosage of 439mg, initiated on 2025-05-26 for Type 2 diabetes and discontinued on 2025-06-13.

On approximately 2025-06-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Pruritus. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed must and advised act. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. 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-2025-193
report_date: '2025-06-16'
patient_details:
  patient_id: ANON-PX-7549
  gender: Male
  relevant_history:
  - osteoarthritis
  - migraines
suspected_drugs:
- drug_name: Lisinopril
  dosage: 379mg
  route_of_administration: Intramuscular
  start_date: '2025-05-26'
  indication_for_use: Hypertension
  end_date: '2025-06-13'
- drug_name: Metformin
  dosage: 439mg
  route_of_administration: Intramuscular
  start_date: '2025-05-26'
  indication_for_use: Type 2 diabetes
  end_date: '2025-06-13'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-06-12'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-06-12'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed must and advised act.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 1
reporting_facility: Acosta and Sons Medical Center
reporter_type: Patient
