<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-2025-836
Date of Submission: 2025-05-24

This report was submitted by a Nurse from Wallace, Freeman and Johnson Medical Center concerning patient ANON-PX-9378. The subject is a 30-year-old male with a significant medical history including seasonal allergies, chronic kidney disease, 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): Lisinopril (ACE inhibitor) administered via the Oral route at a dosage of 70mg, initiated on 2025-04-26 for Hypertension with the course ongoing; Ibuprofen (NSAID) administered via the Subcutaneous route at a dosage of 312mg, initiated on 2025-04-26 for Pain and inflammation with the course ongoing.

On approximately 2025-05-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Anaphylaxis, Headache. The Vomiting was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed himself and advised smile. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed Mr and advised off. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed professor and advised treatment. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 3 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

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report_id: ADR-2025-836
report_date: '2025-05-24'
patient_details:
  patient_id: ANON-PX-9378
  gender: Male
  relevant_history:
  - seasonal allergies
  - chronic kidney disease
  - osteoarthritis
  age_at_reaction: 30
suspected_drugs:
- drug_name: Lisinopril
  dosage: 70mg
  route_of_administration: Oral
  start_date: '2025-04-26'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
- drug_name: Ibuprofen
  dosage: 312mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-26'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-05-16'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed himself and advised smile.
- symptom_name: Anaphylaxis
  onset_date: '2025-05-16'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed Mr and advised off.
- symptom_name: Headache
  onset_date: '2025-05-16'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed professor and advised treatment.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 3
reporting_facility: Wallace, Freeman and Johnson Medical Center
reporter_type: Nurse
notes: Image fight between. Detail agree have how movement. Across government boy
  poor maintain rate statement population.
