<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-2025-334
Date of Submission: 2025-01-21

This report was submitted by a Pharmacist from Allen, Shelton and Perry Medical Center concerning patient ANON-PX-6700. The subject is a 20-year-old female with a significant medical history including atrial fibrillation, migraines. 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 administered via the Intramuscular route at a dosage of 172mg, initiated on 2024-12-17 for Hypothyroidism and discontinued on 2025-01-17; Omeprazole (Proton-pump inhibitor) administered via the Intramuscular route at a dosage of 45mg, initiated on 2024-12-17 for Gastroesophageal reflux disease and discontinued on 2025-01-17.

On approximately 2024-12-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Vomiting. The Angioedema was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed know and advised fear. 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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-334
report_date: '2025-01-21'
patient_details:
  patient_id: ANON-PX-6700
  gender: Female
  relevant_history:
  - atrial fibrillation
  - migraines
  age_at_reaction: 20
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 172mg
  route_of_administration: Intramuscular
  start_date: '2024-12-17'
  indication_for_use: Hypothyroidism
  end_date: '2025-01-17'
- drug_name: Omeprazole
  dosage: 45mg
  route_of_administration: Intramuscular
  start_date: '2024-12-17'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-01-17'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-12-30'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-12-30'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed know and advised fear.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Allen, Shelton and Perry Medical Center
reporter_type: Pharmacist
