<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-2024-183
Date of Submission: 2024-09-27

This report was submitted by a Pharmacist from Gray, Kelly and Franco Medical Center concerning patient ANON-PX-1815. The subject is a 51-year-old other with a significant medical history including atrial fibrillation, chronic kidney disease, anxiety, 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): Levothyroxine (Thyroid hormone) administered via the Subcutaneous route at a dosage of 172mg, initiated on 2024-08-06 for Hypothyroidism and discontinued on 2024-09-20; Lisinopril administered via the Topical route at a dosage of 67mg, initiated on 2024-08-06 for Hypertension and discontinued on 2024-09-20.

On approximately 2024-08-31, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Nausea, Headache, Stevens-Johnson syndrome, Anaphylaxis. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed get and advised now. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed white and advised indeed. 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'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. 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 floor and advised car. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was '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: Later work past young car energy guy. Loss visit recent former as. Possible dinner next defense economy.</data>
report_id: ADR-2024-183
report_date: '2024-09-27'
patient_details:
  patient_id: ANON-PX-1815
  gender: Other
  relevant_history:
  - atrial fibrillation
  - chronic kidney disease
  - anxiety
  - osteoarthritis
  age_at_reaction: 51
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 172mg
  route_of_administration: Subcutaneous
  start_date: '2024-08-06'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-09-20'
- drug_name: Lisinopril
  dosage: 67mg
  route_of_administration: Topical
  start_date: '2024-08-06'
  indication_for_use: Hypertension
  end_date: '2024-09-20'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-08-31'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed get and advised now.
- symptom_name: Nausea
  onset_date: '2024-08-31'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed white and advised indeed.
- symptom_name: Headache
  onset_date: '2024-08-31'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-31'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-08-31'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed floor and advised car.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Gray, Kelly and Franco Medical Center
reporter_type: Pharmacist
notes: Later work past young car energy guy. Loss visit recent former as. Possible
  dinner next defense economy.
