<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-2025-759
Date of Submission: 2025-05-04

This report was submitted by a Nurse from Hart Ltd Medical Center concerning patient ANON-PX-6130. The subject is a 90-year-old other with a significant medical history including migraines, seasonal allergies, asthma, 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): Gabapentin administered via the Intramuscular route at a dosage of 189mg, initiated on 2025-03-08 for Neuropathic pain with the course ongoing; Metformin (Biguanide) administered via the Subcutaneous route at a dosage of 358mg, initiated on 2025-03-08 for Type 2 diabetes with the course ongoing.

On approximately 2025-04-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Stevens-Johnson syndrome, Angioedema, Dizziness. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed medical and advised house. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Life-threatening 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 3 was calculated, The assessment concluded the relationship was 'Possible'. 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: Ago decision activity election strategy special. Gun could man born. Forget vote place start thank.</data>
report_id: ADR-2025-759
report_date: '2025-05-04'
patient_details:
  patient_id: ANON-PX-6130
  gender: Other
  relevant_history:
  - migraines
  - seasonal allergies
  - asthma
  - chronic kidney disease
  age_at_reaction: 90
suspected_drugs:
- drug_name: Gabapentin
  dosage: 189mg
  route_of_administration: Intramuscular
  start_date: '2025-03-08'
  indication_for_use: Neuropathic pain
- drug_name: Metformin
  dosage: 358mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-08'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-04-25'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-25'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed medical and advised house.
- symptom_name: Angioedema
  onset_date: '2025-04-25'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-04-25'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 3
reporting_facility: Hart Ltd Medical Center
reporter_type: Nurse
notes: Ago decision activity election strategy special. Gun could man born. Forget
  vote place start thank.
