<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-2025-838
Date of Submission: 2025-02-02

This report was submitted by a Nurse from Walker Group Medical Center concerning patient ANON-PX-3884. The subject is a 88-year-old other with a significant medical history including seasonal allergies, type 2 diabetes, 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 346mg, initiated on 2024-11-22 for Gastroesophageal reflux disease with the course ongoing; Lisinopril administered via the Topical route at a dosage of 431mg, initiated on 2024-11-22 for Hypertension with the course ongoing.

On approximately 2025-01-22, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Angioedema, Dizziness, Pruritus, Diarrhea. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Angioedema was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed later and advised activity. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: While side order soldier generation forget blue. Example board generation want wall.</data>
report_id: ADR-2025-838
report_date: '2025-02-02'
patient_details:
  patient_id: ANON-PX-3884
  gender: Other
  relevant_history:
  - seasonal allergies
  - type 2 diabetes
  - asthma
  age_at_reaction: 88
suspected_drugs:
- drug_name: Omeprazole
  dosage: 346mg
  route_of_administration: Oral
  start_date: '2024-11-22'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
- drug_name: Lisinopril
  dosage: 431mg
  route_of_administration: Topical
  start_date: '2024-11-22'
  indication_for_use: Hypertension
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-01-22'
  severity: Mild
  outcome: Unknown
  intervention_required: true
- symptom_name: Angioedema
  onset_date: '2025-01-22'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed later and advised activity.
- symptom_name: Dizziness
  onset_date: '2025-01-22'
  severity: Severe
  outcome: Unknown
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-01-22'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-01-22'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 6
reporting_facility: Walker Group Medical Center
reporter_type: Nurse
notes: While side order soldier generation forget blue. Example board generation want
  wall.
