Person who experienced the adverse event (patient)
| Event ID | CASE | I F COD | FOLL SEQ | IMAGE | EVENT DT | MFR DT | FDA DT | REPT COD | MFR NUM | MFR SNDR | AGE | AGE COD | GNDR COD | E SUB | WT | WT COD | REPT DT | OCCP COD | DEATH DT | TO MFR | CONFID | REPORTER COUNTRY |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4413952 | 5741866 | I | 4413952-0 | 20030920 | 20040719 | 20040729 | EXP | HQWYE258320JUL04 | WYETH LABS (RA) | 31 | YR | M | N | 20040728 | OT |
Drug(s) used by person
| Event ID | DRUG SEQ | ROLE COD | DRUGNAME | VAL VBM | ROUTE | DOSE VBM | DECHAL | RECHAL | LOT NUM | EXP DT | NDA NUM |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4413952 | 1005071446 | PS | PROPRANOLOL HYDROCHLORIDE | 1 | ORAL | D | Y | 16418 | |||
| 4413952 | 1005095764 | SS | ALCOHOL (ETHANOL, ) | 2 | D | U | |||||
| 4413952 | 1005095768 | SS | COCAINE (COCAINE, ) | 2 | D | D | |||||
| 4413952 | 1005095771 | SS | PROPOFAN (CAFFEINE/CARBASALATE CALCIUM/CHLORPHENAMINE MALEATE/DEXTROPR | 2 | ORAL | 40 TABLETS | D | D | |||
| 4413952 | 1005095774 | SS | ZITHROMAX | 1 | ORAL | D | D | ||||
| 4413952 | 1005095776 | C | ZIAGEN | 1 | |||||||
| 4413952 | 1005095777 | C | VIDEX | 1 | |||||||
| 4413952 | 1005095780 | C | KALETRA | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4413952 | 1005071446 | SUICIDE ATTEMPT |
| 4413952 | 1005095764 | SUICIDE ATTEMPT |
| 4413952 | 1005095768 | SUICIDE ATTEMPT |
| 4413952 | 1005095771 | SUICIDE ATTEMPT |
| 4413952 | 1005095774 | SUICIDE ATTEMPT |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4413952 | HO |
| 4413952 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 4413952 | COAGULATION FACTOR V LEVEL DECREASED |
| 4413952 | HEPATIC FAILURE |
| 4413952 | INTENTIONAL OVERDOSE |
| 4413952 | PROTHROMBIN TIME PROLONGED |
| 4413952 | RENAL FAILURE ACUTE |
| 4413952 | SUICIDE ATTEMPT |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4413952 | FGN |
| 4413952 | HP |
| 4413952 | OTH |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4413952 | 1005071446 | 20030920 | 20030920 | 1 | DAY |
| 4413952 | 1005095764 | 20030920 | 20030920 | 1 | DAY |
| 4413952 | 1005095768 | 20030920 | 20030920 | 1 | DAY |
| 4413952 | 1005095771 | 20030920 | 20030920 | 1 | DAY |
| 4413952 | 1005095774 | 20030920 | 20030920 | 1 | DAY |