<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-2024-180
Date of Submission: 2024-08-19

This report was submitted by a Nurse from Ross, Day and Mosley Medical Center concerning patient ANON-PX-2107. The subject is a 82-year-old male with a significant medical history including chronic kidney disease, migraines, seasonal allergies, anxiety. 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): Ibuprofen (NSAID) administered via the Intramuscular route at a dosage of 339mg, initiated on 2024-07-29 for Pain and inflammation and discontinued on 2024-08-18; Amoxicillin administered via the Intramuscular route at a dosage of 228mg, initiated on 2024-07-29 for Bacterial infection and discontinued on 2024-08-18.

On approximately 2024-08-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Somnolence, Pruritus, Hepatotoxicity. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed rest and advised there. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 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: According could cup paper. Forward than cover situation. Pass field conference late south interesting avoid.</data>
report_id: ADR-2024-180
report_date: '2024-08-19'
patient_details:
  patient_id: ANON-PX-2107
  gender: Male
  relevant_history:
  - chronic kidney disease
  - migraines
  - seasonal allergies
  - anxiety
  age_at_reaction: 82
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 339mg
  route_of_administration: Intramuscular
  start_date: '2024-07-29'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-08-18'
- drug_name: Amoxicillin
  dosage: 228mg
  route_of_administration: Intramuscular
  start_date: '2024-07-29'
  indication_for_use: Bacterial infection
  end_date: '2024-08-18'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-08-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2024-08-05'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed rest and advised there.
- symptom_name: Pruritus
  onset_date: '2024-08-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-05'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Ross, Day and Mosley Medical Center
reporter_type: Nurse
notes: According could cup paper. Forward than cover situation. Pass field conference
  late south interesting avoid.
