<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-2024-343
Date of Submission: 2024-12-05

This report was submitted by a Nurse from Baldwin-Cook Medical Center concerning patient ANON-PX-6067. The subject is a 89-year-old other with a significant medical history including atrial fibrillation, anxiety, 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): Levothyroxine (Thyroid hormone) administered via the Subcutaneous route at a dosage of 480mg, initiated on 2024-09-28 for Hypothyroidism with the course ongoing; Ibuprofen administered via the Intravenous route at a dosage of 432mg, initiated on 2024-09-28 for Pain and inflammation with the course ongoing.

On approximately 2024-10-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Somnolence, Nausea. The Stevens-Johnson syndrome was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed other and advised need. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed year and advised win. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Out risk out issue base. Here increase hour while these hit decade.</data>
report_id: ADR-2024-343
report_date: '2024-12-05'
patient_details:
  patient_id: ANON-PX-6067
  gender: Other
  relevant_history:
  - atrial fibrillation
  - anxiety
  - asthma
  - osteoarthritis
  age_at_reaction: 89
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 480mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-28'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
- drug_name: Ibuprofen
  dosage: 432mg
  route_of_administration: Intravenous
  start_date: '2024-09-28'
  indication_for_use: Pain and inflammation
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-27'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed other and advised need.
- symptom_name: Somnolence
  onset_date: '2024-10-27'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-10-27'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed year and advised win.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 1
reporting_facility: Baldwin-Cook Medical Center
reporter_type: Nurse
notes: Out risk out issue base. Here increase hour while these hit decade.
