<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-2024-115
Date of Submission: 2024-10-21

This report was submitted by a Nurse from Wiggins Group Medical Center concerning patient ANON-PX-3697. The subject is a 69-year-old male with a significant medical history including atrial fibrillation, chronic kidney disease, seasonal allergies. 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 (ACE inhibitor) administered via the Topical route at a dosage of 380mg, initiated on 2024-10-04 for Hypertension and discontinued on 2024-10-19; Ibuprofen (NSAID) administered via the Oral route at a dosage of 16mg, initiated on 2024-10-04 for Pain and inflammation and discontinued on 2024-10-19.

On approximately 2024-10-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Hepatotoxicity, Nausea, Diarrhea, Stevens-Johnson syndrome. The Headache was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

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 dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Must sport face leader organization should. Believe life you environmental often.</data>
report_id: ADR-2024-115
report_date: '2024-10-21'
patient_details:
  patient_id: ANON-PX-3697
  gender: Male
  relevant_history:
  - atrial fibrillation
  - chronic kidney disease
  - seasonal allergies
  age_at_reaction: 69
suspected_drugs:
- drug_name: Lisinopril
  dosage: 380mg
  route_of_administration: Topical
  start_date: '2024-10-04'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-10-19'
- drug_name: Ibuprofen
  dosage: 16mg
  route_of_administration: Oral
  start_date: '2024-10-04'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-10-19'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2024-10-18'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-18'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-10-18'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-10-18'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-18'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 1
reporting_facility: Wiggins Group Medical Center
reporter_type: Nurse
notes: Must sport face leader organization should. Believe life you environmental
  often.
