<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-2024-891
Date of Submission: 2024-11-17

This report was submitted by a Other Healthcare Professional from Davis-Nelson Medical Center concerning patient ANON-PX-1998. The subject is an adult other with a significant medical history including seasonal allergies, 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): Gabapentin (Anticonvulsant) administered via the Intramuscular route at a dosage of 23mg, initiated on 2024-09-29 for Neuropathic pain with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 266mg, initiated on 2024-09-29 for Hypothyroidism with the course ongoing.

On approximately 2024-10-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Diarrhea, Vomiting, Headache, Hepatotoxicity. The Maculopapular Rash was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed class and advised show. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed stock and advised almost. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 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: I knowledge free this matter land.</data>
report_id: ADR-2024-891
report_date: '2024-11-17'
patient_details:
  patient_id: ANON-PX-1998
  gender: Other
  relevant_history:
  - seasonal allergies
  - atrial fibrillation
  - chronic kidney disease
suspected_drugs:
- drug_name: Gabapentin
  dosage: 23mg
  route_of_administration: Intramuscular
  start_date: '2024-09-29'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
- drug_name: Levothyroxine
  dosage: 266mg
  route_of_administration: Topical
  start_date: '2024-09-29'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-10-12'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-10-12'
  severity: Mild
  outcome: Recovering
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2024-10-12'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed class and advised show.
- symptom_name: Headache
  onset_date: '2024-10-12'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-12'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed stock and advised almost.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 5
reporting_facility: Davis-Nelson Medical Center
reporter_type: Other Healthcare Professional
notes: I knowledge free this matter land.
