<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-2025-688
Date of Submission: 2025-02-05

This report was submitted by a Nurse from Logan, Ryan and Hanson Medical Center concerning patient ANON-PX-2311. The subject is a 84-year-old other with a significant medical history including asthma, coronary artery disease, 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): Omeprazole administered via the Intramuscular route at a dosage of 40mg, initiated on 2025-01-11 for Gastroesophageal reflux disease and discontinued on 2025-01-17; Gabapentin (Anticonvulsant) administered via the Intramuscular route at a dosage of 277mg, initiated on 2025-01-11 for Neuropathic pain and discontinued on 2025-01-17.

On approximately 2025-01-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Hepatotoxicity. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed face and advised few. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-688
report_date: '2025-02-05'
patient_details:
  patient_id: ANON-PX-2311
  gender: Other
  relevant_history:
  - asthma
  - coronary artery disease
  - anxiety
  age_at_reaction: 84
suspected_drugs:
- drug_name: Omeprazole
  dosage: 40mg
  route_of_administration: Intramuscular
  start_date: '2025-01-11'
  indication_for_use: Gastroesophageal reflux disease
  end_date: '2025-01-17'
- drug_name: Gabapentin
  dosage: 277mg
  route_of_administration: Intramuscular
  start_date: '2025-01-11'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-01-17'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2025-01-16'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-01-16'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed face and advised few.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 10
reporting_facility: Logan, Ryan and Hanson Medical Center
reporter_type: Nurse
