<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-2024-722
Date of Submission: 2024-10-21

This report was submitted by a Other Healthcare Professional from Smith, Tanner and White Medical Center concerning patient ANON-PX-6225. The subject is a 63-year-old male with a significant medical history including hypertension, migraines, coronary artery disease, 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): Amoxicillin (Penicillin antibiotic) administered via the Oral route at a dosage of 102mg, initiated on 2024-08-22 for Bacterial infection with the course ongoing; Gabapentin administered via the Intramuscular route at a dosage of 363mg, initiated on 2024-08-22 for Neuropathic pain with the course ongoing.

On approximately 2024-10-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Stevens-Johnson syndrome, Dizziness, Diarrhea. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 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 Dizziness was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-722
report_date: '2024-10-21'
patient_details:
  patient_id: ANON-PX-6225
  gender: Male
  relevant_history:
  - hypertension
  - migraines
  - coronary artery disease
  - seasonal allergies
  age_at_reaction: 63
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 102mg
  route_of_administration: Oral
  start_date: '2024-08-22'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
- drug_name: Gabapentin
  dosage: 363mg
  route_of_administration: Intramuscular
  start_date: '2024-08-22'
  indication_for_use: Neuropathic pain
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-10-05'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-05'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-10-05'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-10-05'
  severity: Mild
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 10
reporting_facility: Smith, Tanner and White Medical Center
reporter_type: Other Healthcare Professional
