<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-2024-324
Date of Submission: 2024-12-16

This report was submitted by a Nurse from Lopez-Cuevas Medical Center concerning patient ANON-PX-5340. The subject is a 30-year-old other with a significant medical history including asthma, atrial fibrillation, coronary artery 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): Warfarin (Anticoagulant) administered via the Oral route at a dosage of 437mg, initiated on 2024-11-08 for Thromboembolism prevention and discontinued on 2024-11-26; Metformin (Biguanide) administered via the Intramuscular route at a dosage of 172mg, initiated on 2024-11-08 for Type 2 diabetes and discontinued on 2024-11-26.

On approximately 2024-11-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Nausea. The Headache was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 was calculated, The assessment concluded the relationship was '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: Protect top majority beautiful know. Stand tax its however. Drive himself rather general number help since.</data>
report_id: ADR-2024-324
report_date: '2024-12-16'
patient_details:
  patient_id: ANON-PX-5340
  gender: Other
  relevant_history:
  - asthma
  - atrial fibrillation
  - coronary artery disease
  age_at_reaction: 30
suspected_drugs:
- drug_name: Warfarin
  dosage: 437mg
  route_of_administration: Oral
  start_date: '2024-11-08'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-11-26'
- drug_name: Metformin
  dosage: 172mg
  route_of_administration: Intramuscular
  start_date: '2024-11-08'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-11-26'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2024-11-09'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-11-09'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 8
reporting_facility: Lopez-Cuevas Medical Center
reporter_type: Nurse
notes: Protect top majority beautiful know. Stand tax its however. Drive himself rather
  general number help since.
