<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-2025-771
Date of Submission: 2025-03-17

This report was submitted by a Other Healthcare Professional from Thompson-Villanueva Medical Center concerning patient ANON-PX-7237. The subject is a 42-year-old female with a significant medical history including asthma, migraines, osteoarthritis, type 2 diabetes. 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 Oral route at a dosage of 144mg, initiated on 2025-03-08 for Hypothyroidism with the course ongoing; Warfarin (Anticoagulant) administered via the Subcutaneous route at a dosage of 174mg, initiated on 2025-03-08 for Thromboembolism prevention with the course ongoing.

On approximately 2025-03-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Somnolence, Pruritus, Dizziness. The Maculopapular Rash was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed water and advised statement. The current patient status regarding this symptom is 'Recovered'. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 3 was calculated, The assessment concluded the relationship was 'Possible'. 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: Entire respond learn range.</data>
report_id: ADR-2025-771
report_date: '2025-03-17'
patient_details:
  patient_id: ANON-PX-7237
  gender: Female
  relevant_history:
  - asthma
  - migraines
  - osteoarthritis
  - type 2 diabetes
  age_at_reaction: 42
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 144mg
  route_of_administration: Oral
  start_date: '2025-03-08'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
- drug_name: Warfarin
  dosage: 174mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-08'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-03-09'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-03-09'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed water and advised statement.
- symptom_name: Pruritus
  onset_date: '2025-03-09'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-03-09'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 3
reporting_facility: Thompson-Villanueva Medical Center
reporter_type: Other Healthcare Professional
notes: Entire respond learn range.
