<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-2025-120
Date of Submission: 2025-02-20

This report was submitted by a Patient from Simon, Watson and Holmes Medical Center concerning patient ANON-PX-7931. The subject is an adult female with a significant medical history including chronic kidney disease, atrial fibrillation, seasonal allergies. 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 (ACE inhibitor) administered via the Subcutaneous route at a dosage of 223mg, initiated on 2024-12-27 for Hypertension and discontinued on 2025-02-01; Gabapentin administered via the Topical route at a dosage of 211mg, initiated on 2024-12-27 for Neuropathic pain and discontinued on 2025-02-01.

On approximately 2024-12-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Pruritus, Anaphylaxis. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed woman and advised face. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed throw and advised PM. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Severe 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 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Trade because old traditional better order. Start appear official pattern article board.</data>
report_id: ADR-2025-120
report_date: '2025-02-20'
patient_details:
  patient_id: ANON-PX-7931
  gender: Female
  relevant_history:
  - chronic kidney disease
  - atrial fibrillation
  - seasonal allergies
suspected_drugs:
- drug_name: Lisinopril
  dosage: 223mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-27'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-01'
- drug_name: Gabapentin
  dosage: 211mg
  route_of_administration: Topical
  start_date: '2024-12-27'
  indication_for_use: Neuropathic pain
  end_date: '2025-02-01'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-12-29'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed woman and advised face.
- symptom_name: Pruritus
  onset_date: '2024-12-29'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed throw and advised PM.
- symptom_name: Anaphylaxis
  onset_date: '2024-12-29'
  severity: Severe
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 10
reporting_facility: Simon, Watson and Holmes Medical Center
reporter_type: Patient
notes: Trade because old traditional better order. Start appear official pattern article
  board.
