<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-2024-229
Date of Submission: 2024-12-14

This report was submitted by a Nurse from Brown, Moreno and Barber Medical Center concerning patient ANON-PX-4686. The subject is a 21-year-old female with a significant medical history including atrial fibrillation, asthma, seasonal allergies. 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): Atorvastatin (Statin) administered via the Intramuscular route at a dosage of 74mg, initiated on 2024-10-09 for Hypercholesterolemia and discontinued on 2024-12-11; Omeprazole (Proton-pump inhibitor) administered via the Oral route at a dosage of 159mg, initiated on 2024-10-09 for Gastroesophageal reflux disease and discontinued on 2024-12-11.

On approximately 2024-11-24, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Dizziness, Pruritus, Anaphylaxis, Maculopapular Rash. The Somnolence was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed point and advised decade. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Card learn woman kitchen soldier human.</data>
report_id: ADR-2024-229
report_date: '2024-12-14'
patient_details:
  patient_id: ANON-PX-4686
  gender: Female
  relevant_history:
  - atrial fibrillation
  - asthma
  - seasonal allergies
  age_at_reaction: 21
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 74mg
  route_of_administration: Intramuscular
  start_date: '2024-10-09'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2024-12-11'
- drug_name: Omeprazole
  dosage: 159mg
  route_of_administration: Oral
  start_date: '2024-10-09'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2024-12-11'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-11-24'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-11-24'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed point and advised decade.
- symptom_name: Pruritus
  onset_date: '2024-11-24'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-11-24'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-24'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 9
reporting_facility: Brown, Moreno and Barber Medical Center
reporter_type: Nurse
notes: Card learn woman kitchen soldier human.
