<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-2024-183
Date of Submission: 2024-09-22

This report was submitted by a Nurse from Lawrence, Collins and Johnson Medical Center concerning patient ANON-PX-2348. The subject is a 78-year-old male with a significant medical history including type 2 diabetes, hypertension, chronic kidney disease, 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): Ibuprofen administered via the Intramuscular route at a dosage of 159mg, initiated on 2024-07-20 for Pain and inflammation and discontinued on 2024-09-05; Omeprazole (Proton-pump inhibitor) administered via the Intravenous route at a dosage of 165mg, initiated on 2024-07-20 for Gastroesophageal reflux disease and discontinued on 2024-09-05.

On approximately 2024-08-08, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Maculopapular Rash, Stevens-Johnson syndrome, Angioedema. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed society and advised small. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. 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: Executive enter base card table determine father. Win seek because unit town.</data>
report_id: ADR-2024-183
report_date: '2024-09-22'
patient_details:
  patient_id: ANON-PX-2348
  gender: Male
  relevant_history:
  - type 2 diabetes
  - hypertension
  - chronic kidney disease
  - asthma
  age_at_reaction: 78
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 159mg
  route_of_administration: Intramuscular
  start_date: '2024-07-20'
  indication_for_use: Pain and inflammation
  end_date: '2024-09-05'
- drug_name: Omeprazole
  dosage: 165mg
  route_of_administration: Intravenous
  start_date: '2024-07-20'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2024-09-05'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2024-08-08'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-08'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-08'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-08-08'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed society and advised small.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Lawrence, Collins and Johnson Medical Center
reporter_type: Nurse
notes: Executive enter base card table determine father. Win seek because unit town.
