<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-2024-263
Date of Submission: 2024-10-29

This report was submitted by a Pharmacist from Hill Ltd Medical Center concerning patient ANON-PX-2205. The subject is a 68-year-old male with a significant medical history including chronic kidney disease, atrial fibrillation. 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 Intramuscular route at a dosage of 393mg, initiated on 2024-08-07 for Type 2 diabetes and discontinued on 2024-10-22; Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 240mg, initiated on 2024-08-07 for Bacterial infection and discontinued on 2024-10-22.

On approximately 2024-08-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Headache, Somnolence, Pruritus, Diarrhea. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Headache was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed strong and advised people. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed doctor and advised get. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Diarrhea 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. A Naranjo score of 8 was calculated, The assessment concluded the relationship was '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: Thing close plan. Ball take protect why need visit. Science participant fill Democrat.</data>
report_id: ADR-2024-263
report_date: '2024-10-29'
patient_details:
  patient_id: ANON-PX-2205
  gender: Male
  relevant_history:
  - chronic kidney disease
  - atrial fibrillation
  age_at_reaction: 68
suspected_drugs:
- drug_name: Metformin
  dosage: 393mg
  route_of_administration: Intramuscular
  start_date: '2024-08-07'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-10-22'
- drug_name: Amoxicillin
  dosage: 240mg
  route_of_administration: Subcutaneous
  start_date: '2024-08-07'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-10-22'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-09'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-08-09'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed strong and advised people.
- symptom_name: Somnolence
  onset_date: '2024-08-09'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed doctor and advised get.
- symptom_name: Pruritus
  onset_date: '2024-08-09'
  severity: Mild
  outcome: Unknown
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2024-08-09'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Hill Ltd Medical Center
reporter_type: Pharmacist
notes: Thing close plan. Ball take protect why need visit. Science participant fill
  Democrat.
