<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-2024-443
Date of Submission: 2024-12-09

This report was submitted by a Physician from Murphy, Flores and Swanson Medical Center concerning patient ANON-PX-1966. The subject is a 64-year-old male with a significant medical history including asthma, osteoarthritis. 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): Levothyroxine administered via the Subcutaneous route at a dosage of 179mg, initiated on 2024-11-26 for Hypothyroidism and discontinued on 2024-12-08; Gabapentin (Anticonvulsant) administered via the Intramuscular route at a dosage of 461mg, initiated on 2024-11-26 for Neuropathic pain and discontinued on 2024-12-08.

On approximately 2024-12-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Maculopapular Rash. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed east and advised top. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash 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 8 was calculated, The assessment concluded the relationship was 'Probable'. 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: Prepare prevent city still best century whom perform.</data>
report_id: ADR-2024-443
report_date: '2024-12-09'
patient_details:
  patient_id: ANON-PX-1966
  gender: Male
  relevant_history:
  - asthma
  - osteoarthritis
  age_at_reaction: 64
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 179mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-26'
  indication_for_use: Hypothyroidism
  end_date: '2024-12-08'
- drug_name: Gabapentin
  dosage: 461mg
  route_of_administration: Intramuscular
  start_date: '2024-11-26'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2024-12-08'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-12-06'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed east and advised top.
- symptom_name: Maculopapular Rash
  onset_date: '2024-12-06'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Murphy, Flores and Swanson Medical Center
reporter_type: Physician
notes: Prepare prevent city still best century whom perform.
