<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-2024-661
Date of Submission: 2024-08-18

This report was submitted by a Other Healthcare Professional from Sawyer and Sons Medical Center concerning patient ANON-PX-8462. The subject is a 27-year-old male with a significant medical history including chronic kidney disease, migraines, atrial fibrillation. 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): Amoxicillin (Penicillin antibiotic) administered via the Topical route at a dosage of 166mg, initiated on 2024-06-18 for Bacterial infection and discontinued on 2024-07-26; Metformin (Biguanide) administered via the Subcutaneous route at a dosage of 441mg, initiated on 2024-06-18 for Type 2 diabetes and discontinued on 2024-07-26.

On approximately 2024-07-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Maculopapular Rash, Headache, Somnolence, Diarrhea. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed no and advised range. The current patient status regarding this symptom is 'Not Recovered'. 

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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Only effort newspaper worry measure there. There realize but usually send program performance.</data>
report_id: ADR-2024-661
report_date: '2024-08-18'
patient_details:
  patient_id: ANON-PX-8462
  gender: Male
  relevant_history:
  - chronic kidney disease
  - migraines
  - atrial fibrillation
  age_at_reaction: 27
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 166mg
  route_of_administration: Topical
  start_date: '2024-06-18'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-07-26'
- drug_name: Metformin
  dosage: 441mg
  route_of_administration: Subcutaneous
  start_date: '2024-06-18'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-07-26'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-07-25'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-07-25'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Headache
  onset_date: '2024-07-25'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2024-07-25'
  severity: Mild
  outcome: Recovering
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2024-07-25'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed no and advised range.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 1
reporting_facility: Sawyer and Sons Medical Center
reporter_type: Other Healthcare Professional
notes: Only effort newspaper worry measure there. There realize but usually send program
  performance.
