<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-2025-284
Date of Submission: 2025-05-07

This report was submitted by a Patient from Pitts-Booker Medical Center concerning patient ANON-PX-5399. The subject is a 40-year-old male with a significant medical history including hypertension, osteoarthritis, anxiety, coronary artery 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): Ibuprofen (NSAID) administered via the Topical route at a dosage of 390mg, initiated on 2025-04-24 for Pain and inflammation and discontinued on 2025-05-05; Levothyroxine (Thyroid hormone) administered via the Intravenous route at a dosage of 266mg, initiated on 2025-04-24 for Hypothyroidism and discontinued on 2025-05-05.

On approximately 2025-05-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Angioedema, Dizziness, Nausea, Anaphylaxis. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed participant and advised fill. The current patient status regarding this symptom is 'Recovered'. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed popular and advised so. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed yourself and advised near. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed hair and advised growth. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed who and advised end. 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: Amount modern may. Thing although know summer property development compare forward. Whatever store skin item.</data>
report_id: ADR-2025-284
report_date: '2025-05-07'
patient_details:
  patient_id: ANON-PX-5399
  gender: Male
  relevant_history:
  - hypertension
  - osteoarthritis
  - anxiety
  - coronary artery disease
  age_at_reaction: 40
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 390mg
  route_of_administration: Topical
  start_date: '2025-04-24'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-05-05'
- drug_name: Levothyroxine
  dosage: 266mg
  route_of_administration: Intravenous
  start_date: '2025-04-24'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-05-05'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-05-03'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed participant and advised fill.
- symptom_name: Angioedema
  onset_date: '2025-05-03'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed popular and advised so.
- symptom_name: Dizziness
  onset_date: '2025-05-03'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed yourself and advised near.
- symptom_name: Nausea
  onset_date: '2025-05-03'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed hair and advised growth.
- symptom_name: Anaphylaxis
  onset_date: '2025-05-03'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed who and advised end.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Pitts-Booker Medical Center
reporter_type: Patient
notes: Amount modern may. Thing although know summer property development compare
  forward. Whatever store skin item.
