<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-2024-791
Date of Submission: 2024-08-21

This report was submitted by a Pharmacist from Guzman-Williams Medical Center concerning patient ANON-PX-1976. The subject is a 32-year-old other with a significant medical history including anxiety, seasonal allergies, osteoarthritis, chronic kidney disease. 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 Oral route at a dosage of 191mg, initiated on 2024-06-22 for Hypertension with the course ongoing; Ibuprofen administered via the Intramuscular route at a dosage of 322mg, initiated on 2024-06-22 for Pain and inflammation with the course ongoing.

On approximately 2024-08-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Angioedema, Diarrhea. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed capital and advised machine. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed high and advised deal. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Mild 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 5 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Sign serious despite develop. Oil prepare beautiful white small attention perhaps. Put ahead mouth note reveal Mrs.</data>
report_id: ADR-2024-791
report_date: '2024-08-21'
patient_details:
  patient_id: ANON-PX-1976
  gender: Other
  relevant_history:
  - anxiety
  - seasonal allergies
  - osteoarthritis
  - chronic kidney disease
  age_at_reaction: 32
suspected_drugs:
- drug_name: Lisinopril
  dosage: 191mg
  route_of_administration: Oral
  start_date: '2024-06-22'
  indication_for_use: Hypertension
- drug_name: Ibuprofen
  dosage: 322mg
  route_of_administration: Intramuscular
  start_date: '2024-06-22'
  indication_for_use: Pain and inflammation
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-08-15'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed capital and advised machine.
- symptom_name: Angioedema
  onset_date: '2024-08-15'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed high and advised deal.
- symptom_name: Diarrhea
  onset_date: '2024-08-15'
  severity: Mild
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 5
reporting_facility: Guzman-Williams Medical Center
reporter_type: Pharmacist
notes: Sign serious despite develop. Oil prepare beautiful white small attention perhaps.
  Put ahead mouth note reveal Mrs.
