<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-2024-961
Date of Submission: 2024-08-19

This report was submitted by a Nurse from Lewis PLC Medical Center concerning patient ANON-PX-2356. The subject is a 77-year-old female with a significant medical history including anxiety, type 2 diabetes, asthma, 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 Intravenous route at a dosage of 197mg, initiated on 2024-06-17 for Hypertension with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 408mg, initiated on 2024-06-17 for Hypothyroidism with the course ongoing.

On approximately 2024-08-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Dizziness. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. 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 dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-961
report_date: '2024-08-19'
patient_details:
  patient_id: ANON-PX-2356
  gender: Female
  relevant_history:
  - anxiety
  - type 2 diabetes
  - asthma
  - osteoarthritis
  age_at_reaction: 77
suspected_drugs:
- drug_name: Lisinopril
  dosage: 197mg
  route_of_administration: Intravenous
  start_date: '2024-06-17'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
- drug_name: Levothyroxine
  dosage: 408mg
  route_of_administration: Topical
  start_date: '2024-06-17'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-08-06'
  severity: Severe
  outcome: Recovered
  intervention_required: true
- symptom_name: Dizziness
  onset_date: '2024-08-06'
  severity: Severe
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Lewis PLC Medical Center
reporter_type: Nurse
