<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-2024-181
Date of Submission: 2024-09-24

This report was submitted by a Patient from Ferguson-Bryant Medical Center concerning patient ANON-PX-9249. The subject is a 22-year-old other with a significant medical history including chronic kidney disease, migraines, 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): Lisinopril administered via the Intramuscular route at a dosage of 494mg, initiated on 2024-06-28 for Hypertension and discontinued on 2024-09-17; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 47mg, initiated on 2024-06-28 for Thromboembolism prevention and discontinued on 2024-09-17.

On approximately 2024-08-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Dizziness. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed same and advised interview. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 

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: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Visit fine care senior light young accept. Level continue sign day.</data>
report_id: ADR-2024-181
report_date: '2024-09-24'
patient_details:
  patient_id: ANON-PX-9249
  gender: Other
  relevant_history:
  - chronic kidney disease
  - migraines
  - coronary artery disease
  age_at_reaction: 22
suspected_drugs:
- drug_name: Lisinopril
  dosage: 494mg
  route_of_administration: Intramuscular
  start_date: '2024-06-28'
  indication_for_use: Hypertension
  end_date: '2024-09-17'
- drug_name: Warfarin
  dosage: 47mg
  route_of_administration: Topical
  start_date: '2024-06-28'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-09-17'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-08-16'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed same and advised interview.
- symptom_name: Dizziness
  onset_date: '2024-08-16'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 3
reporting_facility: Ferguson-Bryant Medical Center
reporter_type: Patient
notes: Visit fine care senior light young accept. Level continue sign day.
