<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-2025-237
Date of Submission: 2025-03-08

This report was submitted by a Physician from Perez-Ayala Medical Center concerning patient ANON-PX-8263. The subject is a 39-year-old male with a significant medical history including hypertension, coronary artery disease. 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): Warfarin (Anticoagulant) administered via the Oral route at a dosage of 230mg, initiated on 2024-12-23 for Thromboembolism prevention and discontinued on 2025-01-18; Lisinopril (ACE inhibitor) administered via the Intramuscular route at a dosage of 47mg, initiated on 2024-12-23 for Hypertension and discontinued on 2025-01-18.

On approximately 2025-01-17, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Maculopapular Rash, Headache, Anaphylaxis, Stevens-Johnson syndrome. The Pruritus was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed audience and advised despite. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Stevens-Johnson syndrome was classified as Moderate 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. 

Reporter's Narrative Summary: Time help similar could. Process another interest start able building. Note experience loss part garden group.</data>
report_id: ADR-2025-237
report_date: '2025-03-08'
patient_details:
  patient_id: ANON-PX-8263
  gender: Male
  relevant_history:
  - hypertension
  - coronary artery disease
  age_at_reaction: 39
suspected_drugs:
- drug_name: Warfarin
  dosage: 230mg
  route_of_administration: Oral
  start_date: '2024-12-23'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-01-18'
- drug_name: Lisinopril
  dosage: 47mg
  route_of_administration: Intramuscular
  start_date: '2024-12-23'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-01-18'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-01-17'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed audience and advised despite.
- symptom_name: Maculopapular Rash
  onset_date: '2025-01-17'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Headache
  onset_date: '2025-01-17'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-01-17'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-01-17'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 10
reporting_facility: Perez-Ayala Medical Center
reporter_type: Physician
notes: Time help similar could. Process another interest start able building. Note
  experience loss part garden group.
