<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-2024-550
Date of Submission: 2024-11-06

This report was submitted by a Nurse from Alvarez PLC Medical Center concerning patient ANON-PX-6707. The subject is a 72-year-old female with a significant medical history including migraines, atrial fibrillation, anxiety. 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): Ibuprofen (NSAID) administered via the Intramuscular route at a dosage of 275mg, initiated on 2024-10-10 for Pain and inflammation and discontinued on 2024-11-05; Levothyroxine (Thyroid hormone) administered via the Oral route at a dosage of 400mg, initiated on 2024-10-10 for Hypothyroidism and discontinued on 2024-11-05.

On approximately 2024-11-02, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Anaphylaxis, Stevens-Johnson syndrome. The Somnolence was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Prevent nature majority how sense strong. Spring however upon me.</data>
report_id: ADR-2024-550
report_date: '2024-11-06'
patient_details:
  patient_id: ANON-PX-6707
  gender: Female
  relevant_history:
  - migraines
  - atrial fibrillation
  - anxiety
  age_at_reaction: 72
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 275mg
  route_of_administration: Intramuscular
  start_date: '2024-10-10'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-11-05'
- drug_name: Levothyroxine
  dosage: 400mg
  route_of_administration: Oral
  start_date: '2024-10-10'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-11-05'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-11-02'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-11-02'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-11-02'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Alvarez PLC Medical Center
reporter_type: Nurse
notes: Prevent nature majority how sense strong. Spring however upon me.
