<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-2025-976
Date of Submission: 2025-08-07

This report was submitted by a Pharmacist from Perez Inc Medical Center concerning patient ANON-PX-7468. The subject is a 70-year-old other with a significant medical history including anxiety, osteoarthritis, asthma. 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 administered via the Subcutaneous route at a dosage of 479mg, initiated on 2025-07-16 for Hypertension and discontinued on 2025-08-02; Levothyroxine administered via the Topical route at a dosage of 95mg, initiated on 2025-07-16 for Hypothyroidism and discontinued on 2025-08-02.

On approximately 2025-07-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Nausea. The Vomiting was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed sort and advised yet. The current patient status regarding this symptom is 'Recovering'. 

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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Lay beyond size set past take we water. Admit seem so experience size. Role capital although there increase community.</data>
report_id: ADR-2025-976
report_date: '2025-08-07'
patient_details:
  patient_id: ANON-PX-7468
  gender: Other
  relevant_history:
  - anxiety
  - osteoarthritis
  - asthma
  age_at_reaction: 70
suspected_drugs:
- drug_name: Lisinopril
  dosage: 479mg
  route_of_administration: Subcutaneous
  start_date: '2025-07-16'
  indication_for_use: Hypertension
  end_date: '2025-08-02'
- drug_name: Levothyroxine
  dosage: 95mg
  route_of_administration: Topical
  start_date: '2025-07-16'
  indication_for_use: Hypothyroidism
  end_date: '2025-08-02'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-07-27'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2025-07-27'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed sort and advised yet.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 7
reporting_facility: Perez Inc Medical Center
reporter_type: Pharmacist
notes: Lay beyond size set past take we water. Admit seem so experience size. Role
  capital although there increase community.
