<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-2024-469
Date of Submission: 2024-10-16

This report was submitted by a Physician from Munoz-Gray Medical Center concerning patient ANON-PX-1156. The subject is an adult other with a significant medical history including asthma, coronary artery 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): Ibuprofen (NSAID) administered via the Oral route at a dosage of 186mg, initiated on 2024-08-03 for Pain and inflammation and discontinued on 2024-08-12; Levothyroxine (Thyroid hormone) administered via the Intravenous route at a dosage of 139mg, initiated on 2024-08-03 for Hypothyroidism and discontinued on 2024-08-12.

On approximately 2024-08-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Pruritus, Nausea. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed view and advised director. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Just action great green three billion. Here agent responsibility discussion.</data>
report_id: ADR-2024-469
report_date: '2024-10-16'
patient_details:
  patient_id: ANON-PX-1156
  gender: Other
  relevant_history:
  - asthma
  - coronary artery disease
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 186mg
  route_of_administration: Oral
  start_date: '2024-08-03'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-08-12'
- drug_name: Levothyroxine
  dosage: 139mg
  route_of_administration: Intravenous
  start_date: '2024-08-03'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-08-12'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-10'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2024-08-10'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed view and advised director.
- symptom_name: Nausea
  onset_date: '2024-08-10'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 2
reporting_facility: Munoz-Gray Medical Center
reporter_type: Physician
notes: Just action great green three billion. Here agent responsibility discussion.
