<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-2024-402
Date of Submission: 2024-11-29

This report was submitted by a Nurse from Proctor, Sosa and Ramirez Medical Center concerning patient ANON-PX-3568. The subject is a 45-year-old other with a significant medical history including type 2 diabetes, migraines, seasonal allergies, asthma. 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 administered via the Subcutaneous route at a dosage of 215mg, initiated on 2024-10-07 for Pain and inflammation and discontinued on 2024-11-25; Lisinopril administered via the Subcutaneous route at a dosage of 22mg, initiated on 2024-10-07 for Hypertension and discontinued on 2024-11-25.

On approximately 2024-11-24, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Dizziness, Pruritus. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed size and advised many. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Life-threatening 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 3 was calculated, The assessment concluded the relationship was 'Possible'. 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-2024-402
report_date: '2024-11-29'
patient_details:
  patient_id: ANON-PX-3568
  gender: Other
  relevant_history:
  - type 2 diabetes
  - migraines
  - seasonal allergies
  - asthma
  age_at_reaction: 45
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 215mg
  route_of_administration: Subcutaneous
  start_date: '2024-10-07'
  indication_for_use: Pain and inflammation
  end_date: '2024-11-25'
- drug_name: Lisinopril
  dosage: 22mg
  route_of_administration: Subcutaneous
  start_date: '2024-10-07'
  indication_for_use: Hypertension
  end_date: '2024-11-25'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-24'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed size and advised many.
- symptom_name: Dizziness
  onset_date: '2024-11-24'
  severity: Mild
  outcome: Fatal
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2024-11-24'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 3
reporting_facility: Proctor, Sosa and Ramirez Medical Center
reporter_type: Nurse
