<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-2025-565
Date of Submission: 2025-06-16

This report was submitted by a Nurse from Hammond, Lamb and Krause Medical Center concerning patient ANON-PX-6112. The subject is a 82-year-old other with a significant medical history including osteoarthritis, 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): Lisinopril (ACE inhibitor) administered via the Topical route at a dosage of 305mg, initiated on 2025-04-19 for Hypertension and discontinued on 2025-05-08.

On approximately 2025-04-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Nausea, Hepatotoxicity, Pruritus, Anaphylaxis. The Stevens-Johnson syndrome was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed make and advised forward. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed particular and advised hard. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. 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: Financial might board quickly test.</data>
report_id: ADR-2025-565
report_date: '2025-06-16'
patient_details:
  patient_id: ANON-PX-6112
  gender: Other
  relevant_history:
  - osteoarthritis
  - chronic kidney disease
  age_at_reaction: 82
suspected_drugs:
- drug_name: Lisinopril
  dosage: 305mg
  route_of_administration: Topical
  start_date: '2025-04-19'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-05-08'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-27'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2025-04-27'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-27'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed make and advised forward.
- symptom_name: Pruritus
  onset_date: '2025-04-27'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2025-04-27'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed particular and advised hard.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Hammond, Lamb and Krause Medical Center
reporter_type: Nurse
notes: Financial might board quickly test.
