<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-2024-984
Date of Submission: 2024-12-29

This report was submitted by a Other Healthcare Professional from Diaz, Edwards and Sims Medical Center concerning patient ANON-PX-1800. The subject is an adult other with a significant medical history including chronic kidney disease, atrial fibrillation, osteoarthritis. 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 Topical route at a dosage of 316mg, initiated on 2024-10-25 for Pain and inflammation and discontinued on 2024-12-27; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 481mg, initiated on 2024-10-25 for Hypothyroidism and discontinued on 2024-12-27.

On approximately 2024-10-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Anaphylaxis, Hepatotoxicity. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed recently and advised lot. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Severe 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 1 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: Claim second store event message wife natural cold. Spring investment sea enjoy can room never improve.</data>
report_id: ADR-2024-984
report_date: '2024-12-29'
patient_details:
  patient_id: ANON-PX-1800
  gender: Other
  relevant_history:
  - chronic kidney disease
  - atrial fibrillation
  - osteoarthritis
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 316mg
  route_of_administration: Topical
  start_date: '2024-10-25'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-12-27'
- drug_name: Levothyroxine
  dosage: 481mg
  route_of_administration: Topical
  start_date: '2024-10-25'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-12-27'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-10-30'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2024-10-30'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed recently and advised lot.
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-30'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 1
reporting_facility: Diaz, Edwards and Sims Medical Center
reporter_type: Other Healthcare Professional
notes: Claim second store event message wife natural cold. Spring investment sea enjoy
  can room never improve.
