<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-2024-383
Date of Submission: 2024-09-29

This report was submitted by a Pharmacist from Zimmerman and Sons Medical Center concerning patient ANON-PX-8657. The subject is a 88-year-old other with a significant medical history including hypertension, asthma. 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 Oral route at a dosage of 89mg, initiated on 2024-08-08 for Thromboembolism prevention and discontinued on 2024-09-26; Amoxicillin administered via the Intravenous route at a dosage of 164mg, initiated on 2024-08-08 for Bacterial infection and discontinued on 2024-09-26.

On approximately 2024-09-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Anaphylaxis, Somnolence, Pruritus, Hepatotoxicity. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity 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 4 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-383
report_date: '2024-09-29'
patient_details:
  patient_id: ANON-PX-8657
  gender: Other
  relevant_history:
  - hypertension
  - asthma
  age_at_reaction: 88
suspected_drugs:
- drug_name: Warfarin
  dosage: 89mg
  route_of_administration: Oral
  start_date: '2024-08-08'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-09-26'
- drug_name: Amoxicillin
  dosage: 164mg
  route_of_administration: Intravenous
  start_date: '2024-08-08'
  indication_for_use: Bacterial infection
  end_date: '2024-09-26'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2024-09-23'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-09-23'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-09-23'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2024-09-23'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2024-09-23'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 4
reporting_facility: Zimmerman and Sons Medical Center
reporter_type: Pharmacist
