title: Evaluation of compliance among nursing staff in administration of prescribed analgesic drugs to critically ill dogs and cats.
abstract: OBJECTIVE
  To investigate the prescription of analgesic drugs to hospitalized critically ill dogs and cats and determine compliance of nursing staff in administering the prescribed analgesics.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  272 dogs and 79 cats hospitalized in an intensive care unit during a 2-month period.
  
  
  METHODS
  Patient treatment orders were examined daily for details regarding prescribed and administered analgesic drugs.
  
  
  RESULTS
  A mean of 39% of cats and dogs in the intensive care unit were prescribed analgesic drugs each day, the most common of which were opioids. Local anesthetic drugs, nonsteroidal anti-inflammatory drugs, and ketamine were prescribed less frequently. Cats were less likely than dogs to receive analgesics after traumatic injury, but the difference was not significant. There was no difference between species in frequency of prescription of analgesic drugs after surgery. Most patients were prescribed a single class of analgesic drug; only 13% had orders for multiple analgesics. Of the patients for which analgesics were prescribed, 64% received them exactly as prescribed, 23% had at least 1 reduction in dosing, and 13% had at least 1 increase in dosing. When a decrease in dosing occurred, the drugs were opioids in each instance, whereas when drug dosing was increased, the drugs were of various types.
  
  
  CONCLUSIONS
  Discrepancies sometimes existed between the dose of analgesic prescribed and that administered. This appeared to occur primarily because of concerns about adverse effects of opioid drugs. Strategies to reduce these effects may improve pain management in critically ill dogs and cats.
authors.affiliation: Section of Anesthesia, Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Armitage
authors.forename: Lois A
authors.initials: LA
authors.lastname: Wetmore
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Chan
authors.forename: Jane C
authors.initials: JC
authors.lastname: Lindsey
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017750:Animal Technicians / Q000523:psychology; D000818:Animals; D002371:Cat Diseases / Q000188:drug therapy* / Q000601:surgery; D002415:Cats; D002983:Clinical Competence; D016638:Critical Illness; D003430:Cross-Sectional Studies; D004283:Dog Diseases / Q000188:drug therapy* / Q000601:surgery; D004285:Dogs; D011307:Drug Prescriptions; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D006762:Hospitals, Animal; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D000700:Analgesics