<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-2024-232
Date of Submission: 2024-09-17

This report was submitted by a Physician from Kim, Wolf and Castillo Medical Center concerning patient ANON-PX-5870. The subject is an adult female with a significant medical history including hypertension, osteoarthritis, 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): Omeprazole (Proton-pump inhibitor) administered via the Topical route at a dosage of 319mg, initiated on 2024-06-25 for Gastroesophageal reflux disease and discontinued on 2024-08-16; Lisinopril administered via the Subcutaneous route at a dosage of 208mg, initiated on 2024-06-25 for Hypertension and discontinued on 2024-08-16.

On approximately 2024-08-02, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Dizziness, Maculopapular Rash. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed garden and advised small. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed remember and advised drive. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. 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: Foreign notice trade hour process. Detail look sense grow six I.</data>
report_id: ADR-2024-232
report_date: '2024-09-17'
patient_details:
  patient_id: ANON-PX-5870
  gender: Female
  relevant_history:
  - hypertension
  - osteoarthritis
  - atrial fibrillation
suspected_drugs:
- drug_name: Omeprazole
  dosage: 319mg
  route_of_administration: Topical
  start_date: '2024-06-25'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2024-08-16'
- drug_name: Lisinopril
  dosage: 208mg
  route_of_administration: Subcutaneous
  start_date: '2024-06-25'
  indication_for_use: Hypertension
  end_date: '2024-08-16'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-02'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed garden and advised small.
- symptom_name: Dizziness
  onset_date: '2024-08-02'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed remember and advised drive.
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-02'
  severity: Severe
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 5
reporting_facility: Kim, Wolf and Castillo Medical Center
reporter_type: Physician
notes: Foreign notice trade hour process. Detail look sense grow six I.
