<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-2025-881
Date of Submission: 2025-04-09

This report was submitted by a Pharmacist from Ramos and Sons Medical Center concerning patient ANON-PX-8554. The subject is a 30-year-old other with a significant medical history including migraines, coronary artery disease, atrial fibrillation, osteoarthritis. 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): Sertraline (SSRI) administered via the Intramuscular route at a dosage of 178mg, initiated on 2025-01-19 for Major depressive disorder and discontinued on 2025-03-22; Metformin administered via the Oral route at a dosage of 268mg, initiated on 2025-01-19 for Type 2 diabetes and discontinued on 2025-03-22.

On approximately 2025-01-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Anaphylaxis. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 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: Data type region build century win. Sing issue again position close suffer.</data>
report_id: ADR-2025-881
report_date: '2025-04-09'
patient_details:
  patient_id: ANON-PX-8554
  gender: Other
  relevant_history:
  - migraines
  - coronary artery disease
  - atrial fibrillation
  - osteoarthritis
  age_at_reaction: 30
suspected_drugs:
- drug_name: Sertraline
  dosage: 178mg
  route_of_administration: Intramuscular
  start_date: '2025-01-19'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-03-22'
- drug_name: Metformin
  dosage: 268mg
  route_of_administration: Oral
  start_date: '2025-01-19'
  indication_for_use: Type 2 diabetes
  end_date: '2025-03-22'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-01-23'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2025-01-23'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 9
reporting_facility: Ramos and Sons Medical Center
reporter_type: Pharmacist
notes: Data type region build century win. Sing issue again position close suffer.
