<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-2025-613
Date of Submission: 2025-03-12

This report was submitted by a Other Healthcare Professional from Morrison, Adkins and Jackson Medical Center concerning patient ANON-PX-6895. The subject is an adult female with a significant medical history including chronic kidney disease, asthma. 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 Oral route at a dosage of 273mg, initiated on 2025-02-28 for Gastroesophageal reflux disease with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Oral route at a dosage of 174mg, initiated on 2025-02-28 for Hypothyroidism with the course ongoing.

On approximately 2025-03-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Nausea, Somnolence. The Pruritus was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed include and advised really. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed chance and advised finally. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Change room event morning. Most because with air teacher experience.</data>
report_id: ADR-2025-613
report_date: '2025-03-12'
patient_details:
  patient_id: ANON-PX-6895
  gender: Female
  relevant_history:
  - chronic kidney disease
  - asthma
suspected_drugs:
- drug_name: Omeprazole
  dosage: 273mg
  route_of_administration: Oral
  start_date: '2025-02-28'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
- drug_name: Levothyroxine
  dosage: 174mg
  route_of_administration: Oral
  start_date: '2025-02-28'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-03-06'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed include and advised really.
- symptom_name: Nausea
  onset_date: '2025-03-06'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2025-03-06'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed chance and advised finally.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Morrison, Adkins and Jackson Medical Center
reporter_type: Other Healthcare Professional
notes: Change room event morning. Most because with air teacher experience.
