<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-2025-666
Date of Submission: 2025-04-06

This report was submitted by a Physician from Ramirez Inc Medical Center concerning patient ANON-PX-7013. The subject is a 89-year-old male with a significant medical history including osteoarthritis, type 2 diabetes, hypertension. 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 Topical route at a dosage of 177mg, initiated on 2025-02-25 for Pain and inflammation with the course ongoing.

On approximately 2025-03-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Nausea, Maculopapular Rash. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed song and advised teacher. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed worry and advised thousand. The current patient status regarding this symptom is 'Recovering'. 

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. 

</data>
report_id: ADR-2025-666
report_date: '2025-04-06'
patient_details:
  patient_id: ANON-PX-7013
  gender: Male
  relevant_history:
  - osteoarthritis
  - type 2 diabetes
  - hypertension
  age_at_reaction: 89
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 177mg
  route_of_administration: Topical
  start_date: '2025-02-25'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-03-21'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-03-21'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed song and advised teacher.
- symptom_name: Maculopapular Rash
  onset_date: '2025-03-21'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed worry and advised thousand.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Ramirez Inc Medical Center
reporter_type: Physician
