<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-2024-885
Date of Submission: 2024-11-04

This report was submitted by a Pharmacist from Holloway, Moreno and Carroll Medical Center concerning patient ANON-PX-6477. The subject is a 34-year-old female with a significant medical history including anxiety, asthma, osteoarthritis. 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): Metformin (Biguanide) administered via the Oral route at a dosage of 304mg, initiated on 2024-08-12 for Type 2 diabetes with the course ongoing.

On approximately 2024-08-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Nausea, Maculopapular Rash. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

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: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-885
report_date: '2024-11-04'
patient_details:
  patient_id: ANON-PX-6477
  gender: Female
  relevant_history:
  - anxiety
  - asthma
  - osteoarthritis
  age_at_reaction: 34
suspected_drugs:
- drug_name: Metformin
  dosage: 304mg
  route_of_administration: Oral
  start_date: '2024-08-12'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-08-16'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-08-16'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-16'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 10
reporting_facility: Holloway, Moreno and Carroll Medical Center
reporter_type: Pharmacist
