<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-2024-411
Date of Submission: 2024-09-10

This report was submitted by a Patient from Meadows, Lopez and Gomez Medical Center concerning patient ANON-PX-2789. The subject is a 56-year-old other with a significant medical history including atrial fibrillation, chronic kidney disease. 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 administered via the Topical route at a dosage of 470mg, initiated on 2024-06-12 for Hypothyroidism and discontinued on 2024-08-13; Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 153mg, initiated on 2024-06-12 for Hypertension and discontinued on 2024-08-13.

On approximately 2024-08-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Somnolence, Vomiting. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

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

Reporter's Narrative Summary: You best trouble course specific owner. Film picture hope sound court him name trial. Risk can stock open put.</data>
report_id: ADR-2024-411
report_date: '2024-09-10'
patient_details:
  patient_id: ANON-PX-2789
  gender: Other
  relevant_history:
  - atrial fibrillation
  - chronic kidney disease
  age_at_reaction: 56
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 470mg
  route_of_administration: Topical
  start_date: '2024-06-12'
  indication_for_use: Hypothyroidism
  end_date: '2024-08-13'
- drug_name: Lisinopril
  dosage: 153mg
  route_of_administration: Intravenous
  start_date: '2024-06-12'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-08-13'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-08-05'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-08-05'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-08-05'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 9
reporting_facility: Meadows, Lopez and Gomez Medical Center
reporter_type: Patient
notes: You best trouble course specific owner. Film picture hope sound court him name
  trial. Risk can stock open put.
