<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-2025-434
Date of Submission: 2025-07-09

This report was submitted by a Nurse from Castillo and Sons Medical Center concerning patient ANON-PX-8962. The subject is a 31-year-old female with a significant medical history including osteoarthritis, atrial fibrillation, 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): Omeprazole (Proton-pump inhibitor) administered via the Intramuscular route at a dosage of 343mg, initiated on 2025-06-11 for Gastroesophageal reflux disease with the course ongoing; Lisinopril administered via the Oral route at a dosage of 191mg, initiated on 2025-06-11 for Hypertension with the course ongoing.

On approximately 2025-07-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Dizziness, Nausea. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed better and advised measure. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed team and advised him. 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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Certainly when third. Certain season worry them kind century official.</data>
report_id: ADR-2025-434
report_date: '2025-07-09'
patient_details:
  patient_id: ANON-PX-8962
  gender: Female
  relevant_history:
  - osteoarthritis
  - atrial fibrillation
  - seasonal allergies
  - anxiety
  age_at_reaction: 31
suspected_drugs:
- drug_name: Omeprazole
  dosage: 343mg
  route_of_administration: Intramuscular
  start_date: '2025-06-11'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
- drug_name: Lisinopril
  dosage: 191mg
  route_of_administration: Oral
  start_date: '2025-06-11'
  indication_for_use: Hypertension
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2025-07-01'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed better and advised measure.
- symptom_name: Dizziness
  onset_date: '2025-07-01'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-07-01'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed team and advised him.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Castillo and Sons Medical Center
reporter_type: Nurse
notes: Certainly when third. Certain season worry them kind century official.
