<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-2025-986
Date of Submission: 2025-05-19

This report was submitted by a Physician from Fisher-Quinn Medical Center concerning patient ANON-PX-5548. The subject is a 24-year-old female with a significant medical history including chronic kidney disease, osteoarthritis, seasonal allergies. 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 Topical route at a dosage of 455mg, initiated on 2025-03-02 for Hypertension with the course ongoing; Ibuprofen (NSAID) administered via the Subcutaneous route at a dosage of 333mg, initiated on 2025-03-02 for Pain and inflammation with the course ongoing.

On approximately 2025-05-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Somnolence, Vomiting, Dizziness. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed heart and advised ten. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed information and advised television. 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 rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Center order a support center. Group strong animal cover until task owner. Development ask think goal especially. Month thus management administration serious.</data>
report_id: ADR-2025-986
report_date: '2025-05-19'
patient_details:
  patient_id: ANON-PX-5548
  gender: Female
  relevant_history:
  - chronic kidney disease
  - osteoarthritis
  - seasonal allergies
  age_at_reaction: 24
suspected_drugs:
- drug_name: Lisinopril
  dosage: 455mg
  route_of_administration: Topical
  start_date: '2025-03-02'
  indication_for_use: Hypertension
- drug_name: Ibuprofen
  dosage: 333mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-02'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-05-12'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed heart and advised ten.
- symptom_name: Somnolence
  onset_date: '2025-05-12'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-05-12'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
- symptom_name: Dizziness
  onset_date: '2025-05-12'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed information and advised television.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Fisher-Quinn Medical Center
reporter_type: Physician
notes: Center order a support center. Group strong animal cover until task owner.
  Development ask think goal especially. Month thus management administration serious.
