<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-2024-654
Date of Submission: 2024-09-05

This report was submitted by a Nurse from Le and Sons Medical Center concerning patient ANON-PX-2453. The subject is a 69-year-old other with a significant medical history including hypertension, type 2 diabetes, anxiety, migraines. 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): Gabapentin (Anticonvulsant) administered via the Topical route at a dosage of 151mg, initiated on 2024-06-09 for Neuropathic pain and discontinued on 2024-08-12.

On approximately 2024-07-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Nausea, Stevens-Johnson syndrome, Headache, Hepatotoxicity. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed sing and advised boy. The current patient status regarding this symptom is 'Fatal'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed box and advised inside. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed bar and advised again. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Public manage prevent important claim. Dream people road Mr machine PM continue. Available too start worry.</data>
report_id: ADR-2024-654
report_date: '2024-09-05'
patient_details:
  patient_id: ANON-PX-2453
  gender: Other
  relevant_history:
  - hypertension
  - type 2 diabetes
  - anxiety
  - migraines
  age_at_reaction: 69
suspected_drugs:
- drug_name: Gabapentin
  dosage: 151mg
  route_of_administration: Topical
  start_date: '2024-06-09'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2024-08-12'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-07-11'
  severity: Severe
  outcome: Unknown
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2024-07-11'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-07-11'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed sing and advised boy.
- symptom_name: Headache
  onset_date: '2024-07-11'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed box and advised inside.
- symptom_name: Hepatotoxicity
  onset_date: '2024-07-11'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed bar and advised again.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Le and Sons Medical Center
reporter_type: Nurse
notes: Public manage prevent important claim. Dream people road Mr machine PM continue.
  Available too start worry.
