<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-2024-946
Date of Submission: 2024-09-24

This report was submitted by a Other Healthcare Professional from Parker, Ramirez and Davis Medical Center concerning patient ANON-PX-8083. The subject is a 23-year-old female with a significant medical history including type 2 diabetes, anxiety, atrial fibrillation. 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): Amoxicillin (Penicillin antibiotic) administered via the Intramuscular route at a dosage of 487mg, initiated on 2024-07-14 for Bacterial infection with the course ongoing; Lisinopril (ACE inhibitor) administered via the Oral route at a dosage of 339mg, initiated on 2024-07-14 for Hypertension with the course ongoing.

On approximately 2024-07-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Vomiting, Stevens-Johnson syndrome, Dizziness, Diarrhea. The Headache was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed present and advised these. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Life-threatening 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 7 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-946
report_date: '2024-09-24'
patient_details:
  patient_id: ANON-PX-8083
  gender: Female
  relevant_history:
  - type 2 diabetes
  - anxiety
  - atrial fibrillation
  age_at_reaction: 23
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 487mg
  route_of_administration: Intramuscular
  start_date: '2024-07-14'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
- drug_name: Lisinopril
  dosage: 339mg
  route_of_administration: Oral
  start_date: '2024-07-14'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Headache
  onset_date: '2024-07-30'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-07-30'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-07-30'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-07-30'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed present and advised these.
- symptom_name: Diarrhea
  onset_date: '2024-07-30'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 7
reporting_facility: Parker, Ramirez and Davis Medical Center
reporter_type: Other Healthcare Professional
