<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-2025-215
Date of Submission: 2025-02-21

This report was submitted by a Nurse from Patterson-Barnes Medical Center concerning patient ANON-PX-5576. The subject is a 89-year-old female with a significant medical history including coronary artery 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): Omeprazole (Proton-pump inhibitor) administered via the Oral route at a dosage of 279mg, initiated on 2024-12-22 for Gastroesophageal reflux disease with the course ongoing; Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 182mg, initiated on 2024-12-22 for Hypertension with the course ongoing.

On approximately 2025-02-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Maculopapular Rash, Stevens-Johnson syndrome, Nausea. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed teach and advised oil. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed night and advised entire. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed make and advised address. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Indicate word current water set.</data>
report_id: ADR-2025-215
report_date: '2025-02-21'
patient_details:
  patient_id: ANON-PX-5576
  gender: Female
  relevant_history:
  - coronary artery disease
  - atrial fibrillation
  age_at_reaction: 89
suspected_drugs:
- drug_name: Omeprazole
  dosage: 279mg
  route_of_administration: Oral
  start_date: '2024-12-22'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
- drug_name: Lisinopril
  dosage: 182mg
  route_of_administration: Intravenous
  start_date: '2024-12-22'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-02-04'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed teach and advised oil.
- symptom_name: Maculopapular Rash
  onset_date: '2025-02-04'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-02-04'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed night and advised entire.
- symptom_name: Nausea
  onset_date: '2025-02-04'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed make and advised address.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 1
reporting_facility: Patterson-Barnes Medical Center
reporter_type: Nurse
notes: Indicate word current water set.
