<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-2024-320
Date of Submission: 2024-09-02

This report was submitted by a Pharmacist from Kaufman Ltd Medical Center concerning patient ANON-PX-5418. The subject is a 61-year-old male with a significant medical history including chronic kidney disease, coronary artery disease, asthma, atrial fibrillation. 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): Warfarin (Anticoagulant) administered via the Intramuscular route at a dosage of 432mg, initiated on 2024-07-28 for Thromboembolism prevention with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Oral route at a dosage of 416mg, initiated on 2024-07-28 for Hypothyroidism with the course ongoing.

On approximately 2024-08-31, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Headache. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 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: Service general beautiful drug. Keep space visit population at process. Suffer down social leader you husband weight forward.</data>
report_id: ADR-2024-320
report_date: '2024-09-02'
patient_details:
  patient_id: ANON-PX-5418
  gender: Male
  relevant_history:
  - chronic kidney disease
  - coronary artery disease
  - asthma
  - atrial fibrillation
  age_at_reaction: 61
suspected_drugs:
- drug_name: Warfarin
  dosage: 432mg
  route_of_administration: Intramuscular
  start_date: '2024-07-28'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
- drug_name: Levothyroxine
  dosage: 416mg
  route_of_administration: Oral
  start_date: '2024-07-28'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-08-31'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-08-31'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 1
reporting_facility: Kaufman Ltd Medical Center
reporter_type: Pharmacist
notes: Service general beautiful drug. Keep space visit population at process. Suffer
  down social leader you husband weight forward.
