<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-2024-267
Date of Submission: 2024-11-28

This report was submitted by a Pharmacist from Strickland, Richards and Kelly Medical Center concerning patient ANON-PX-5049. The subject is a 64-year-old female with a significant medical history including migraines, anxiety, seasonal allergies, hypertension. 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 Subcutaneous route at a dosage of 9mg, initiated on 2024-11-17 for Bacterial infection and discontinued on 2024-11-26; Lisinopril (ACE inhibitor) administered via the Topical route at a dosage of 232mg, initiated on 2024-11-17 for Hypertension and discontinued on 2024-11-26.

On approximately 2024-11-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Anaphylaxis, Headache, Maculopapular Rash. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed player and advised traditional. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed eight and advised score. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 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. 

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report_id: ADR-2024-267
report_date: '2024-11-28'
patient_details:
  patient_id: ANON-PX-5049
  gender: Female
  relevant_history:
  - migraines
  - anxiety
  - seasonal allergies
  - hypertension
  age_at_reaction: 64
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 9mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-17'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-11-26'
- drug_name: Lisinopril
  dosage: 232mg
  route_of_administration: Topical
  start_date: '2024-11-17'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-11-26'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-11-21'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-11-21'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed player and advised traditional.
- symptom_name: Headache
  onset_date: '2024-11-21'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-21'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed eight and advised score.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 6
reporting_facility: Strickland, Richards and Kelly Medical Center
reporter_type: Pharmacist
notes: That film growth million sister. Short mention something. Rest education somebody
  cell majority law situation doctor. Finally reveal news seven so.
