An Analytical Cross-Sectional Observational Study on Drug Utilisation and Evaluation of Narrow Therapeutic Index Drugs in a Tertiary Care Hospital

Narrow therapeutic index drugs (NTIDS) are medications that requires careful handling because even small changes in the dose or blood levels can make the medicine not work, cause harm, or lead to serious side effects. These drugs need to be prescribed correctly, monitored closely, and followed exactly as per clinical guidelines. This study focused on the use of NTIDS in a tertiary care hospital to understand how they are prescribed, whether they are used rationally, and what drug-related problems (DRPs) occur. The results showed that more than half of the prescriptions were irrational, and many patients experienced at least one DRP, showing major gaps in safe medications practices. One approach used was monotherapy, which was meant to reduce drug interactions. The high number of DRPs showed that there are still problems with prescribing and monitoring. NTID use was more common among women and people aged 18 to 39 years, with Heparin, Levothyroxine, and Amikacin being the most prescribed drugs. Many patients also had other health conditions, like diabetes or hypertension, which made treatment more complicated. These findings highlight the need for standard treatment plans, ongoing education for prescribers, and more involvement of clinical pharmacists. Making drug utilization evaluation a daily activity can help reduce errors, improve patient outcomes, and enhance the quality of healthcare.