<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-2024-739
Date of Submission: 2024-08-28

This report was submitted by a Pharmacist from Brandt PLC Medical Center concerning patient ANON-PX-1649. The subject is a 84-year-old male with a significant medical history including asthma, migraines, chronic kidney 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): Metformin (Biguanide) administered via the Intravenous route at a dosage of 332mg, initiated on 2024-06-19 for Type 2 diabetes and discontinued on 2024-08-18; Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 359mg, initiated on 2024-06-19 for Bacterial infection and discontinued on 2024-08-18.

On approximately 2024-07-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Anaphylaxis, Maculopapular Rash. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis 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 Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

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

</data>
report_id: ADR-2024-739
report_date: '2024-08-28'
patient_details:
  patient_id: ANON-PX-1649
  gender: Male
  relevant_history:
  - asthma
  - migraines
  - chronic kidney disease
  - anxiety
  age_at_reaction: 84
suspected_drugs:
- drug_name: Metformin
  dosage: 332mg
  route_of_administration: Intravenous
  start_date: '2024-06-19'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-08-18'
- drug_name: Amoxicillin
  dosage: 359mg
  route_of_administration: Subcutaneous
  start_date: '2024-06-19'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-08-18'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-07-29'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-07-29'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-07-29'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 10
reporting_facility: Brandt PLC Medical Center
reporter_type: Pharmacist
