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Misdiagnosis or incomplete evaluation treating symptoms, not causes Outdated knowledge poor awareness of latest guidelines Polypharmacy & comorbidities one drugs benefit becomes anothers risk System workflow gaps lack of pharmacist review or CDS alerts Time pressure especially in high-volume OPDs or wards Over 50% of preventable medication harm occurs during the prescribing stage (Hodkinson et al., BMC Medicine, 2020) Wrong drug errors remain one of the top medication faults (Velo & Minuz, Br J Clin Pharmacol, 2009) Common Examples Seen in India Antibiotics for viral infections (irrational use) Broad-spectrum antibiotics when narrow-spectrum suffice Dual statins or anticoagulants without indication NSAIDs in renal impairment Steroids in undiagnosed infections Such mismatches are red flags during NABH audits especially under Medication Management (MOM.4 & MOM.5) standards emphasizing rational use and prescription appropriateness

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This is particularly relevant because the cardiac muscle has limited capacity to synthesize LC (Flanagan et al

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