<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-2024-185
Date of Submission: 2024-11-21

This report was submitted by a Other Healthcare Professional from Flores, Black and Williams Medical Center concerning patient ANON-PX-4784. The subject is a 71-year-old other with a significant medical history including type 2 diabetes, coronary artery disease, osteoarthritis. 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): Metformin (Biguanide) administered via the Intravenous route at a dosage of 243mg, initiated on 2024-10-06 for Type 2 diabetes and discontinued on 2024-11-06; Gabapentin administered via the Oral route at a dosage of 247mg, initiated on 2024-10-06 for Neuropathic pain and discontinued on 2024-11-06.

On approximately 2024-10-17, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Anaphylaxis, Somnolence, Headache. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed treatment and advised instead. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed thank and advised main. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed blood and advised production. The current patient status regarding this symptom is 'Fatal'. The Headache 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. 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. 

Reporter's Narrative Summary: Skin add keep recent able. Middle investment back state.</data>
report_id: ADR-2024-185
report_date: '2024-11-21'
patient_details:
  patient_id: ANON-PX-4784
  gender: Other
  relevant_history:
  - type 2 diabetes
  - coronary artery disease
  - osteoarthritis
  age_at_reaction: 71
suspected_drugs:
- drug_name: Metformin
  dosage: 243mg
  route_of_administration: Intravenous
  start_date: '2024-10-06'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-11-06'
- drug_name: Gabapentin
  dosage: 247mg
  route_of_administration: Oral
  start_date: '2024-10-06'
  indication_for_use: Neuropathic pain
  end_date: '2024-11-06'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-10-17'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed treatment and advised instead.
- symptom_name: Anaphylaxis
  onset_date: '2024-10-17'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed thank and advised main.
- symptom_name: Somnolence
  onset_date: '2024-10-17'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed blood and advised production.
- symptom_name: Headache
  onset_date: '2024-10-17'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Flores, Black and Williams Medical Center
reporter_type: Other Healthcare Professional
notes: Skin add keep recent able. Middle investment back state.
