<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-2025-614
Date of Submission: 2025-01-27

This report was submitted by a Other Healthcare Professional from Warren, Chavez and Sparks Medical Center concerning patient ANON-PX-8975. The subject is an adult other with a significant medical history including migraines, 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): Lisinopril administered via the Intramuscular route at a dosage of 410mg, initiated on 2025-01-10 for Hypertension and discontinued on 2025-01-20.

On approximately 2025-01-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Hepatotoxicity, Somnolence. The Angioedema was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed key and advised sign. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

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: Sea worry recent positive. Relationship peace stop.</data>
report_id: ADR-2025-614
report_date: '2025-01-27'
patient_details:
  patient_id: ANON-PX-8975
  gender: Other
  relevant_history:
  - migraines
  - anxiety
suspected_drugs:
- drug_name: Lisinopril
  dosage: 410mg
  route_of_administration: Intramuscular
  start_date: '2025-01-10'
  indication_for_use: Hypertension
  end_date: '2025-01-20'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-01-18'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed key and advised sign.
- symptom_name: Hepatotoxicity
  onset_date: '2025-01-18'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-01-18'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 1
reporting_facility: Warren, Chavez and Sparks Medical Center
reporter_type: Other Healthcare Professional
notes: Sea worry recent positive. Relationship peace stop.
