Washington Manual of Medical Therapeutics 30

download Washington Manual of Medical Therapeutics 30

of 831

Transcript of Washington Manual of Medical Therapeutics 30

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    1/829

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    2/829

    +3 +4 5678 % .1! - (

    +3 54 !

    +3 4

    +3 4 ) +#3 +# 2

    +3 4 +9# - "

    +3 "4 ##: 3

    +3 24 -##

    +3 %4 # "#

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    3/829

    /

    ! ! "" # # $ # "

    " % !# # & '" () * '" " + *,& " - * ' * ( *

    $ # ." / *0 . $##! 1 $' '& ." 1 +))- 2) * ." 1 -3 *

    40 %# 2 ** " "" 5 *

    6

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    4/829

    . 7#" . !

    !

    # ()

    ! ! "# ! !# +))- ! () ! " ! 8 # 9 . . * . : * " ;

    . $ ! # %! !

    ' '

    ; +

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    5/829

    !# ! ! # 4 ' 1 ' # " ' $ ' +5 "

    ' ! !" 4?:4?." '? . '" @! " ' 7 . 7#" 4

    ' B> 7

    =!D C D > C 9B

    >$

    4:

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    6/829

    '" () *

    , 4" $ C '

    2 %: ; ."

    + .:! ">E!"

    $ !

    /) !) !$%E.> "

    ! / !

    $" " 2 !

    % "

    ! 7

    " !

    # ! "

    2 %:

    $" " # # ! #1 ):4$ " # %

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    7/829

    " # ! % F % "! %

    4 %

    $ +# # ! * # # " "#" $ # "F "#

    9 ! : " G" $. =$$> .H- +" " # + " "

    ( 2 ( "& G 9H

    I G" 9 J

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    8/829

    4 !

    $ +) I

    # " $! # " ? " :" # ! " - - ! ! " " !!

    ! + > 8 #( 4$ #

    8 " $%

    2 #1# % A ! " !F " "

    8 " " ! 3 - @ : ." $

    *.'$; " ! ! " ! "

    9 "" " " # # # ?A " # L" () GH + GHM

    +

    > I ! " I! F *! " " G "

    " I " ! !HD %D ! # D ! "AD : ! #

    # ! ! " # $

    4 F ! "!

    # ! ! 6 # ! # % 8 ! !

    # ! 3# " !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    9/829

    " # 9 # % # F # +# 3! ! 2 # " # " # #

    %" #" " )2 " G 2H -N+ " =

    # 3 $ #

    3 !#G() -&- %H # # # 7 6##! ?/+@ !4

    4 ! # # "! # #E # ! !

    ! # ! " ! #!3# ) " $ 8 %" " # # " ! ! "

    4 ") !# #= )! # %" %# !

    ) 1

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    10/829

    - +! # "! " " # $ " L(+3N/3) " GH I2M $ #! # ! # # # 8

    + %!# ?@ 1= # ! # I " %! !"

    # # 8 # (

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    11/829

    (4 #A! # !F #A! # $ #

    " " " + I : #

    # $! 4 ! " ! # % #

    $ +# " # !? - 4$ (+3N-))) " I2N/

    G% 2 "EH !# # I # !

    ! + +) 4 !"

    " % ; % # ! ! -)N-3 " G +/H

    9 + " ? - 4$ "! " (+3N-))) "

    I2 G% ( "EH G())N/)) " I(N2H # " ! !## *? # A " #

    + +) 4 6 FF " ! 2 1 ! #! %!)! " # "

    # # " #

    # "! >$. 3) $ #

    ( + 4 - " $ # ! #"

    !" " " ". # ! " #

    /+! " ? # # %" $ >$. ! # ! 3 /+ 1 8 8 # G +2H B ## "

    # "! = !D ! % 3 >%

    . !3!6 ?36@ 1 %?+

    # %" %?+ # !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    12/829

    #4 " !# 31 314 3# !# # ! %?+ %?+ # # ! " # >$. 31 8 6!

    #4* ; "

    " " # -?- I" "

    1 64*I" "-

    I G??H " GH #" *

    # " ! I " I I # " ! #

    #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    13/829

    G+3N-)) " I2N/H "

    ! ! %? . " ? "

    ;3! 3! #

    # $!# # % G3 "E(+3 " I/H % G23 "E(+3 " I/H % G3) "E(+3 " -)) "E/3) " I/H

    # "! #

    ! " " -)N-3 " I2N/

    " "! !# # ! 5+ $ "

    3 6 G# #% FH !"

    ! "( 4 ;

    " " " G" A # H ; 1 8 $8 G" #!

    ! #H ! # 1 9 4 ! F #FF ! ! ! F # G% # 7 #H " # + $ " G" %H ( ' # F # "

    ! ! 2 +) 3 4$" !

    # I" / # -!

    = ) !

    =

    2 !"

    !" # ! %! > !" # # "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    14/829

    # 9FF " G F H # %" #

    >! # # #

    : # # #- 49 3) -)) " I2N/ #

    : ! "

    + +) 4>

    ! # ! > FF

    # # # " # !# 1 8 = +;4

    7 +) C1 ?@ )D #! #3 " % #!

    /) !) !

    4 +3!A#

    $ ##4 /)6! 3! " # @ " #FF %- # # # ! "

    # % # #

    G #?# # H 5) 3

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    15/829

    2 /)6! >

    9 5:: ! % ! % @ # # # # -?+!

    #FF "

    1 64 #FF

    - #!4 #FF " % !# ! # :# 3:##:# !D " #

    ! $" # :# ! " " # " F D F #

    % 5:: 3! # ! " > F 5:: 8 6) # ! " " ? #

    + - 3! # !

    # -?+ # " " #:# # -N+ # #

    # # F F G +3H

    /= # # ! # #FF .F+N-) " NI # # # A

    5 ! F +N3 " = F -N( " = ! +N3 ! % 8

    # # " I" #FF F% F

    I G +3H( 3!

    / FF " # # F !" ! " " # # !" "

    # ! ! " %

    % " ( # :# #:# #

    !

    " -! ! 8 ! ##4

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    16/829

    #FF ! ! +N2 88 !##" -N-) " # ! $" ! #

    ! # # "

    " # !" F ?" ?" " # # -)N+)P ! 3 D "?" # I

    5 % # !

    > " " 3 " " -) " + # 2N/

    . E# F "

    # # " "

    7 Q # ) 8 1) 4 " 3 " -) " " +) " . #

    * E #FF

    " ? % - !# FF Q # " 3 " -)N+) "

    : ! ?+@ ! G % H "F % # $ !#! $ %

    7 : # !% " "

    " ! > ! ! # F $ # " F G $% H

    ; ! # !" A" # # !"

    ;)66 # # % " #

    ! " $"

    "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    17/829

    4

    $ ##4

    # ! # 4 ! # # # F 4 # # # ! # # 8

    9 #! ! ? ! G# -?(H$!# ! ! .!

    ! ? " $ ! ! " # ! D #

    1 64 - +

    # 4$ # " #

    ! " ! #F # ! # " ! $ I

    !# " # !

    # # !F # " " ! " " +#! # ;! "

    # #

    " ! "" 3) " I " # # +3 3) " ! +N( % +))N())"E ! I +N2 ! "

    ) # + ## ) @ 9 "! " # - " "

    # / 34G +/ "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    18/829

    !H + # ! # " # # " " ) $

    *7 " " R R! ? ! " 1

    8 ) 8 )4$ ! 8 #! G$% H %!)! A / !" "" /

    % " F $ # # !4 !

    # " + /) = 1 ?//-@

    ? # G # -?(H " # #"

    #F # ! //- ) 1 #18 +; 8 $ ! +; 47 "

    " # ! ? -3 G (N2 H ? " F#?# #? ! " ! ! -

    # +)N2) "E $ ! " # 23) F "3 # # #!?! :% !#

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    19/829

    % " 4 . ## 1 ! #" '

    ( : # ! %

    : F "

    >F F = 4

    2 5 ? " #F ! !

    # " ? FD #

    F " % ' # " "# " $ % " -)) " # #

    -)) " 2N5 ? "

    -3)N()) "E + 68= 8

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    20/829

    G" " H ! : # # # " ! " #I ?" " 3 " = "!

    ! 2N/ 9 #F > #!# %"" ! $

    1 8 / //-4F % ! # "

    # !" $ F 7 # % ! I % # ##

    ; ! ! !% )3 # #! " " ! F # " ! % 9 ! # " ! 3)N-3) "E $" !" #F " "# # # ! !"

    4 ! !" #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    21/829

    " ! $ !"

    $ 86 ! # ?" " $"

    " % ! ?" " G 45H " # " " G 4544H- #F%F !! "

    " " " R! # ;: #FF

    -?"

    " " " 3N+) "

    G #FF !! -? +?

    " -3)N53) "E ! H! ! 3# " I : #FF!! " " ? F " + 5 # 1 1 )! I8= # =4 " ())N23) "E !

    9 ;6

    - # 4 " ! " N?" ? -)N+) " " #

    " # # #

    +

    + ! !##4 " -N3 " G H = # ! "

    R ! # " #

    # G "H "

    # ! !4 # F F! G % #

    H " # % F 3)N2)) "EDF +)N/) "ED F -N-3 "ED

    -N-3 "E "?" A# !# F

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    22/829

    )#4 : "! " 3N-) " = I +3 " #. "

    1 # #: ! G -)N+3 " I2N/D +3N3) " I(N2D

    +3N-)) " I/NKH " # #"

    # # ## ! 8

    # ##! ! G #" " " !" !" " E " H

    "? " ? "

    #! ?"" )+3 " # ! ; ! %! " 7 #

    " 8 # "

    ?" G 4+H/8 !# " !" ! #! ! "" !

    ! ? # # +) 4 " ? " F

    " " D "?" " # % - ! # !

    " " = " #" ) I # . %#

    + + # !

    ( 3!# !

    F # "" " " *! !#+3N3) " 1:- " = # I = I " #F G-N+ " H += ! #

    # " #

    " #?$" " #FF " ! # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    23/829

    " ) != ! F #! ! " A % # !# "

    2 # !# I "

    " ! 9 ! " #

    # # ! ! '9 G +3H

    3 . ## ) " )! # ! " " 9

    " "# " = !D

    " " ( # # ! "

    / : 3! FF ! "D

    F # F " " '9

    ! /

    " " "

    !" ! *!" ! "" # 8 " # ! #" # # % ;! " %! " #F # #

    4 )

    $ ) # = F !

    "" " $ ! # ! " G$ % %+5&

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    24/829

    # # # I! G*H # ! " " ;" " " " !! ! " " "

    "* " # "

    ! " :" -?-F ! " # " 7 " " ! G%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    25/829

    9 %#!# #4 " ? " "? "! G" ( " A"! H " !! "

    ! ! G !" !H " # 2K !

    ! # #F !

    - +6) :!# 1 3 # ! " $ ! " #

    "! + + # !

    # # G" = #?""H ! " "? !" ! ! " #

    ! #?" " # ! G

    -+2&5/K -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    26/829

    3 8 )) " G -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    27/829

    " " # # ! : # 31! " # 7 #D ! #

    ! ""! # %F" ) 1 # !

    ! 9 ) ## I " %"

    # " # " #! /) # 1 ! F

    # I # .#" % G" ! H "

    "" ! " ! ! I ! " # $# # # I #

    4 + ! ! # -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    28/829

    H ! # " A " I

    $ 9)

    # " #" " ! " ! ! # " # ! ! ! # " F- ( 9) F # "

    # ! 5N-) # (

    ! # ! G" " " H ' !

    " " " " F F " " # !

    + 5 9) " 9? # % 9 GH " I # F % 9 GH I ! -)P I G" H # # " " # " # !

    2 #! 9)I# G H G -2H$ # # "

    ( + 9) " " #"" A! $" # ! >F# G" H ! " - " # # " # ! ;# !# 1 4

    2 3 !) 9) ! " $# " !! " "

    9 9! # # - 9) 1 #

    " $

    $ ! .

    A! #" ?" % '8 # "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    29/829

    # # ! - # = 8 $ 4$" #I 3) 1I " ! +1 #)1 # # # # ! #

    " " " 4 8 ! # ! # "

    ) 1 # 14

    + 1 ###!4$# # "! # 114

    (4 2# F # "! ! # !

    "

    $ ;6 # " # # " # " % " ! ?" " " # # " " " #?" " # # G#F FH " # GH # #

    # " IG (H

    9 +6 # # I

    " # " A! % $

    D #D D!"D ! D E " " + 6 = 1 #! 8 # " F +3) " =D ))3P - " #D )3P - " #

    ;# -+

    (4 ;# #

    $ ;# 1 !# -)P - " I I " ! # " # ! > ! # !

    9 ;# 1 1 ! 1! # "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    30/829

    %# " )3P

    I # + 6 = # GH # ! G (45H # #

    ! # " " - " +3P G>?H )3P + 1!

    . ; F F

    " " !# # GH ! ! # ! !

    ! # "? "

    (4 /!# # #4

    $ " G #H " # " % ! " 7 >

    9 + " # G H " % 1 # J # 1 ) 8= 1 ! )

    1 ! 3!4 # ! #

    + " G !H

    " ! ! .! " !

    . 16+ " G !# #%

    H ## " !" ! # # "!

    " " 9% ! !

    * 1 ! 1 " GFFH # # " % 7 " # ;

    " F # F # F

    : ! ! G H

    " % :" 7

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    31/829

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    32/829

    5 # # 9 # " # #

    9 /! "

    " 3 # " "

    % #/ # !# *% " F " # # #

    " #

    ; ## # #4 . " "" F # " +! " G H # G # H /

    " # # "

    . - !- ! = #

    5 # # F #" *% 9 # # %

    #! 4 .1 # # I # ## " $!# $I * >! ?"

    + 3) # " I " # G H " #! ! % " " # # G 4H # #!

    * 1 "

    " F # # 8 # !" # ! "- ! G# -?3H

    1 6&4 "

    + /!# #G;-? "H %F +3N3) " I/ !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    33/829

    " G --H

    ( ##4 # E ! # -?3"F " # "

    - 54 #" "

    ! # # " # " F " "

    + /4 ! # %

    : " # $ -P " " # % )-P

    % ;"?

    # # ! " ! # ! ;"? ? %

    ( 4."

    $ # #NI ' " +3N2) " ! #

    2 ;4 # # ! ! ? % %! !!

    2 /= - 11 ) # ! %!

    ## # " I

    + 5 # # ! " ! # # #

    4 #

    $ :# # F # % " A ! #" " ! "

    # E I = #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    34/829

    ! " "? " %! !! # )3N-) "E"E ( ! -) ! G %! !H I (

    # ! G 4H9 #G" FH

    " ! #" F # " " # "*!

    I #

    I % # !

    > #4 --

    . 4 " #

    ! # G I # # H ##" " #F # # ? # F F =

    # * 3 # ! ?@ " #

    #" " ()P # " " $ # ?" # *> # " " # #F ## " " " F %" $ " # "

    !: /)67 !#4 --

    >%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    35/829

    '" () *

    !

    4

    5 +# - )! #

    $ " " F A I # " ## I# # " #

    4 5

    $ ! 4" #8 A ! ." ! " # A " # # !! F !!" ! " !# # . ! # " G

    S(3P # "H G S()P # H G S5)P # H # F L# %

    G9H -( "E+ -- "E+ M G 454H

    9

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    36/829

    # " !" G 454H

    1 64* " I F # # % G9H

    # %65

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    37/829

    1 64 ( ! 4 # F # ! #

    F ?( ?/ +P )3P !

    & GS)2H #

    # G H2 1!4 #

    ! #F I " G U 2) "EH # " G U -+) "EH

    3 9 #4A I# # "

    G ! !H G)3N3) " /)N-3) *IH G+N3 " /)N-)) *IH" G())N2)) " KN+2 *IH GK))N-+)) " 3N-3 *IH GK))N-+)) " -+N+2 *IH

    / ? # )#@4

    ! F % ?# !

    ?# ! G# +?(H ! #! !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    38/829

    ?" $ Z" [ !" F # ! !! ! % A # ! # " # " %

    $ / 4$ % # # # " A ! G # +?(H

    9 6! #4 ?"

    ;! # A

    # ! I # # #A!

    ! G (4+H- %!4 # # #

    ! ! " 8 # I ! " 5! 84 GJ3PH G3N-)PH

    ! GS-)PH # " / # # " -)P " # " / G $ /

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    39/829

    # # " " ! "

    " # # " G " % % H % # G

    H( .1! #

    G # +?(H ! G" # # ?#" H # :% # G % %

    -)&()3 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    40/829

    # ?##@ #G" =!%H " GJ3P H G33)N/3) E"H # I # " %" !" " $#

    " I "! /## ?#@

    #G" = H F !#

    # " #F ?# ? ?# G" 9 H

    # # ?# # #

    ? # # ! ? F !# ? " % -

    E -/P 33P # ()P G" * H #

    ? ? " G H %! ! # ! "! #! F ?#

    !# ! "?" G" H "? G" ;>H I #? G" C!H !" "? # "

    ( ; ! 4 # # " !" ?" # # # ! 7 ?# L% -+G $H&-+

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    41/829

    "- /6# ?M' 8=@ 1 # ! #

    ?# " " # # " ! # 9

    # # # " # $" " "

    " " A " AA " " #

    + .6# ?N' 8=@ 1 I " AA # # "

    " " % #! # ()

    !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    42/829

    #4 1 ## # # # -3P D ) # "

    " % 7 1 # "

    !F "! " ? GJ-) :H# :I " # ()N/) !" " Z[ ! I " # ?! " G-) H

    F G= ! H " # # # !

    ! ## %!!#4" # " #?

    # # "" # " ? # # " -))) E !"

    ? ! -+ "! G+2 EH " $ " "

    " # ! "% # " 8 # # # " " # "

    #! 4 " #

    #? # % # " " " $" " ! # " " # " # " #" ! %8) 1 11 1! 2 ! 8 # ?44 !! #1 @ 4G& $ (2(&-)25 +)))H ! % # " " " # ! " "

    !" " " "? G" " " # I !"D" " # "H #"

    2 # !" # E . ! # " 3)P . # G $& $ &-3&+55 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    43/829

    A

    (4

    $ 2 4 # ZI[ Z"[ # I ! ! ;! # # ZI[ Z"[ 8 # ?%" ! # " # " # # I GJ3)P IH 5 ;! #

    9 ?@

    - 4 G S-3)) EH I "?# "? ! F ! " #! ! F ! A ! ! " I > A" ! $" % # # " ! )

    ?@ % # ! > I # !

    + ! # " 2)N3)P

    3)N/)P "

    " " ! G # +?+H %F

    # " ! ! # #? ! !

    ! # 2 ?3@ = D " %

    ! (2 $ -3) " " %F # # !" " I "

    . # !# -)P G-- EH +)P G+)EH ! "

    * F #F I" " ""? !

    " !" # " # I " "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    44/829

    # # +)N()P # %-) E"E G)-- "E"EH # ! # !" G% '! 5&()/ - " !# # % !# G$+2(&-

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    45/829

    "" ? # ! # 3 \ F ! 3)N-)) \ G% &-)&--2 - # +?K

    1 6,4" ? %1! #4; #

    > # G!

    H " G # H

    L * GH ,G5 H& C9 - ( * ! # #!" G+)N2)PH " > " KN-) E "" "# " !" %! # !" "? > # !# ! ! " ! # ! # # #

    !" # ' " # > ! ! # "" $ 2? F % # #

    1 1 # #! !""? GS( H > # ! " ! F ! # %

    # G ( &--&

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    46/829

    # " % ! . % "! #

    ?@ ! # " ## ;! A "

    " -) " " & G-H ! 3)P "

    ""?# %N G+H 3))N-))) 3 " G #H G(H ?# ++? +(?"" ! N " ! # % " IG2H 3?" " G -E2 +P "

    H ! G3H ! G/H ! # (3)) E G5H

    -+?\ G &-)&2

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    47/829

    I O !#P " - %!# !=# !##4

    " "# ?

    % : % # - "E "

    I "! G $ % &(2&(

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    48/829

    >%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    49/829

    '" () *

    " ! #

    7 7 "

    2 # " #

    /

    # >X*: ! *: ! %;;

    #

    ;;

    #;

    ;

    ;;

    #;"

    " +65 1$ # " G$97H ?# #@ " # #

    2 # "

    4 ! # ! ! # I # # ?# #

    $ ## 8

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    50/829

    ! # " " # 7 # ## (?- =

    1 64

    9 ! " >X 4X I #" "" # "

    >XB >X%

    3 E # >X !

    3)N-3) >X G >H 7 4 X G+)N/)EH I #

    % G-))N-3) "EH "! F # !

    + # ( # # ! # +N(

    G 3P % +) E 4 " ! - G +H ;! ! ! G ' (4+H

    4 -# 1# 8 !

    $ 1 8 # # '

    # -))N-3) E " # ! (5

    : " ! G-))N+))) EH ! # # ! " F # # 3P%

    9 2 ! ! " # #

    - >X # " " ! # G$>H #!

    4 ! $> # G$H # " "

    . - !# %! # ! # # A # " ! I #

    /

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    51/829

    4 1! 8 L4' % /)P #" 3)P # # A& ? G:H ? %

    G*:H #! ! -&2 ;#!

    *: G>X " H : G4X " H ) #! ! I# # #D ! G: ! *:H A

    GK3NX % ' > X# "

    " L>XM " #

    : ! >X *: !

    % # >X#

    4 " )#

    $ 4 # " FF ! " ! . " # " ! ! A" ! " ! # '"

    " ! " ! ! B %" $ " % "

    *: ! #

    " % >X 9@>E ! " G -+H *:! ! !

    GH #

    9 !4*: ! # >X

    % % > X # G" H

    G>X"H *%! > X " $> # # > ! 7 G!" " "H ? G# H "

    #4 " ! "" ! # ! ! ! I = "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    52/829

    " = ! I # ?" G# %H G) -32 E >XH ! # ! I

    G()P > 3-( E >XH ; # 4 X% # #" 4 :

    " ! "

    4 " )# 3

    $ 49 53NK)P *: %! *: !% % #4

    # # " " ! (N2 ! " ! A"

    ! A" % ( "

    9 !4*: ! % #

    >X # #

    $! >X# # ! "

    ! # G"

    H # *: ! % # " " ! ! ! -+ / -5 !

    (4 %!# L>XM -(3 E # " ?

    : ! L>X " ? ! ! ? I %

    & G-H " ! G H "

    G+H ! # > X N

    " # ; G(H # " # !

    G H $# % !

    $ %!# 8 8 # #!4

    G" : !H "

    # " > X *: ! " # >X #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    53/829

    - %!# 8 " )#

    > X G 45H $ ! ! ! "

    % ; ! I ? : ! G" !"H #

    " 4X " %" G4 X%

    >X H #

    + %!# 8 " )# 3 I ;: ! ! " ! "

    ! ! # >X % #

    # " ! " " " # % 8 # % I! !

    ( %!# 8 # " )# !# #

    ?/+%@ ! # " ! " % $.;

    " $.; F # G-H ? G+H G S-)) E"HG(H ! G2H

    # 2 ! !!# # $.; $" # $8 ! G ?" H G !H #

    " G7:H !

    # #

    & G-H ! G" #F " " H G+H

    ! L" % ? " G>$.HM G(H ! " L"% G..$=HM

    ! # ! # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    54/829

    ? !!" + !3 ! ! #! ! !

    ! " % -+ E !

    # " F # "

    9 %!# 8 # # #!- !#

    I X !

    " I L> XM

    G% >X?! " H

    L>XM

    " %

    + %!# 8 !# # " *: " " : *: ; # " =

    R! L> XM # -2E ! -)) "E " "

    # G - $ .//&5- - XM X LNM

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    55/829

    "4 64$" " G*: V

    % D $.; V HL: 77 " 9 9 : * .# $: GH /0 ! G-3 H > ,& 7?; +))- M- # #!49 *: #

    L>XM ! #

    + > #! )#4 ? % % ! "! -)) E" -))(! "" % ! ! # " #

    ! % !# % # " /))N LL I49 >X A *: " *: !

    # > X ! " #

    >X# L>XM X LNM +) E

    " L> XM X LNM " +) E ! !"

    * #4 " & G-H L> XMG" : !H # " "

    G+H >X 4XGH G(H " " "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    56/829

    I - " )# 4"

    >X " ! " : !

    + # 4; !

    " >X

    % >X I

    > X % . #

    4 X

    L>XM ' $.;

    ( !# # " G ,(3+&++) -XM # # -N+ EE # 3

    E " L>XM # # K

    E " +2 I > X I

    >X # "! #

    # " " L> XM # # G" 3 E Y () V -3) V ()) (P >H

    !## L>XM # # )( EE I K E ! +2

    3 ' = *:!N ! ! # # ! # ! " %

    / !# /+% # # " " % # ? " % # # %

    # >X

    # % $.; ! % %

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    57/829

    % # # G" " H # " " % ." " #8 # ! " #

    ! ! !!

    (4 %!# L>XM " -23 E I# : ! ; # #

    >X" # % ! % " !

    $ # 4 " # ! # @ # # #! ! " # # ! " " " " !

    9 %!# 8 A 9 # # : *:

    +&- "! ? " " # I! " # : *: - 8 # !

    G# H 7 #

    ! % % !# ! .

    7 G # # # #H !

    " %" >X 4X

    + - 8 # # I " " # = G"? H ;

    # G-H " # F # ! G+H 1 ?@ ! 1 G.H " "

    ! . # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    58/829

    I # #! ! >. " GH G" H

    %!# L I # G.4$H

    G L>XM U3) EH ! > >; ( " "

    . 8 *: : G"

    F #H ; #

    *: ! " # "* 4 A "

    #

    " F : . ? " ! %! " $ ! "

    L>XM " ! " !

    : G:" (?+H $ % ! " %

    " "

    "4 64$" " G..$= V D *: V % H L: 77 " 99 : * .# $ : GH/0 ! G-3 H > ,& 7?;+))- M

    - +# )# #! ! % ! G3)) EH % G SK)) E"H

    " "" % >X $ >X% # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    59/829

    *: ! % G L> XM S-)) EH #% % G !Y H " # % I

    $ ! % % . @ "

    !

    7 #4 " G-H "" G+H *: ! # ! I I # " I&

    K Q ?# CLD 6 $@A$ R 3 1! 8 ?.@

    - 4$

    " # " F "" # ! 2KN5+ ' "

    "" # L> XM # # )3 EE # -+ E ! +2 # ! " # $! ? I? # "! =

    + 4 . " ..$=

    ( 4 " >. # !# # "

    " " " "

    # >. # ?>X F

    ! % # ! !

    " >$. ! # !

    #

    # A L4 XM (3N3)

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    60/829

    E % -3) E

    4X *: +P # 4 X

    >XN4XN$ ! >X 4X (&+

    ! 4 X I!

    " " # 4 X !

    !" ' % - E"E

    4X ## # % ! # ; >

    4X # " 4 X%

    ! # 4 X ! # " G.H = "

    4X% # 4X# !"

    4X !# "

    # " ?"!

    ! 4 X !

    # >X " G NH *I

    # >X N I!

    # >X % N "

    " # " $ " "

    L4XM 4 X

    L4 XM . 4X % 9 % I ! "

    4X

    4 %!=#

    $ 4 4 X ! " ! "

    L4XM () E :" " %

    ! "! !

    ! 4X

    # ? # *7

    " L4XM *" " ! ! @ !

    " " R@ ! ! 4 X " ! !" " R

    % ! ;

    " %

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    61/829

    ; ?# #

    " 4 X %

    ;(N# " ; X

    # " # I >. 4 X

    9 !4; L4XM (3 E "&

    - # = 4X # % # ! -3 E

    ;! 4X %# 7

    + 4! 4X

    L4XM " # 4 X " " ! - E #

    4X" #

    4X# %!

    4X .4$ :

    " 4 X ?

    #+?" " 4X

    # $# # 4X " ! 9-+ "?" ?"

    ! # .4$

    ( BL4 ! 4X !" "

    4X% " ! # # ;!

    " 4 X # ##

    " !" 4X ; #I

    7 ! !! G=H %! #

    *%! " ! 4X

    " 4X G *:

    ! H

    2 - BL

    # # 4 X . " . #

    4X G*# +K&

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    62/829

    # !

    # >X " GH % #! !# # " # %!#G

    H ! " ?" ; ! "

    ! * 4 X " %

    --#?% " " " #

    #% "8

    ! > X ###

    G N

    H ! 4X

    !" .4$ # " !! G -H $

    4X 9

    # >X 4X 4X"

    G:" (?(H " 4 X # # . %! # !" # # # % $" %

    4X 4X % -3

    E 4X ; 4 X%

    "" 4X ! 7

    !" 4 X" # #

    L4XM . *: ! 9 ?#

    %! 4X

    "4 64$" " G$ V

    # D 47 V # 4 X "H L: 77

    " 9 9 : * .# $ : GH /0 ! G-3 H > ,&

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    63/829

    7?; +))- M

    1 BL ?B2@

    " ! !" 4 X G,(3+&-(3

    -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    64/829

    ( ( !4 ! # " # I = 4

    % 4X # 2)E ! ! /) E ! ! % +) E "

    ! 4 # % # % %#

    # ? ! 4X =

    4X # A I #! G*7

    %H

    4 %!=#

    $ 4 %

    L4XM *7 " ?! ! !" " ! R ! ! "! " R % "" ! ?!

    ! ! # ; F #

    # %# " ! !!; # " # >; 2

    X

    ; % # %# # 4X!

    9 !4; L4XM " 3) E

    - BL= "

    !F 4X

    + !=# ! L4 XM

    4X! # " !#" "

    " # #! "

    G H L4XM

    ( 4 # 4X # % " #

    " #" ;X

    G" "H 4 X :

    *: *%? 4 X !# #

    #?# # !

    L4XM ;

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    65/829

    .F" %

    L4 XM ! #

    2 BL3 !

    ! . 4X > X# N#

    # L14. # G$8 H " F ; # ! # " # !"

    4X?" "?!" F G$*H # >$. F# " ! ?"

    # 4X?" ! " #

    >X "

    4X # #" > X# >$. # ! "

    7: 4X $*# # ! " " "

    $* #N # ! "

    ! # 4 X?" >$. $ # " " ; I

    " 4 X % !

    ! 4X# 7: # -)N-3 E "

    # I1 ?I@4; #

    # I ! %" """

    N# " $ # # % G$ ) &!+&-+5

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    66/829

    $. G:" (?2H ' %

    # 4X% " # % # "# " " !

    # 4X" 4 X*! *: ! " ! %

    % +)) 4 X

    4X # 4X # ! # " 47 G 4H $ 47

    5 !" 4 X #

    # # !"

    L" G:H 3)N+)) " M # # %" ? % ! # "

    >X G>X J-) EH # ! $?

    ! > X

    # ! N

    " *: ! " !

    N# !

    %

    "4 6$4$" " G$* V"?!" FD >$. V ?

    "D $ V # D 47 V # 4X"H L: 77 " 9 9 : * .# $ : GH /0 ! G-3 H> ,& 7?; +))- M

    . #4 " *7 " - + !4! " I

    F" # F !

    " 4X ! % ()N

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    67/829

    #A! 4X *%" 4X " # +# # #

    %# -) -)P ! +N( #" # ! G()N/)

    H # " *7 3N-)

    # 4X

    L4XM $" " %"

    G " ! "H $ # -)N+) " +3N3) " ";" # "! " !

    L4XM # )3N-3 E -3N() !

    += ! 8 ( %; 4X

    ( E 3P% G-(2 E >;(H # !

    ! # ?" !

    >X ! % 16

    #F 4 X ()

    " L4XM # )3N-3 E +N2

    . : # 4X

    % I

    3

    G4%H %" >X 4X 7 '"! # +3N3) " % -)) +)P

    # ! " L4 XM# )3N-) E -N+ 2N/ # " 3) " -3) * # !

    ! # "

    " ! # ! ! ?" !

    !! ! 4 X# -3N+)P !

    + !4: " # !! # ! % %"

    #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    68/829

    # # $%

    K3P " " -3P " -P ! ! G H # # #

    9 ! # "

    F " ! A # " %! # !! # # " # % ;?

    ! ; # # ; D ?! "

    ; " # I " " # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    69/829

    ! " !! #!

    ; !# G ! .% ? #FH ! F

    # ! G" H"# ! !#

    F #

    . #" %-+ "E # ! ! 7

    % !" >" " " *7

    R ! !" " % " #! -( "E ? !

    * !#I

    " # ! " " ! F

    F # - ! ! 3# G-H

    G+H G(H ! G2H "

    " G " H # / #!

    + # % ) # $ " ; # ;! !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    70/829

    F *: !G 4"4H # $ # # # "! D " ! # # % #"! " #

    # # ! ! " #

    = ? - " )# )

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    71/829

    " :I " % " " #" " % $

    / 2 # #" # # #"

    # # " % ! " " ! . % +)N3) " # I! 3N-) $ #F

    # " % G +2H

    " "? 5 ; # #

    # # ! ( "E F ? . )3N-) "

    G H #

    I # % 23 "E G "EH % /) ? = ! #

    K !4; " ! ! " ;:

    7 ## !#- !#! !

    # #" " " # "! # # # . # #

    # # ! ! G-H #

    G+H G(H # G + ! # "H G2H % -+ "E G3H " " 3) G/H # "? ? " # ! # " # ;!

    # # "

    ! /? -+? ! 9 # " ?" " "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    72/829

    # ! "! #

    # !#! # " %

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    73/829

    # F # # # " )K "E ! - "E # # 2 "E 8 # # ) ? G "H ! " "

    # ! . G; H #

    $ ! ! ." " " G #H # GF H " G 4"H

    $ #! "

    # $ " #" # ! %#

    ! " S ! 9 #! ( )=S " ! " !4! " " F *7 " R ! # ""

    9 ! ! 3# G-H! " G ! " ! H G+H

    G" !"HG(H G # H G2H " " G3H ! . G/H " G H .1! " ; ! ! " " ! . ; ! "

    + ## #

    " # + " # G-K) " +) -)P "H = ! -) # / " " 3)) .3' ! 2N/ G-) -)P " V - "H # I2N/ # A ! ! # K < "E " # "? =

    # " %!## # G " 4H "%

    *7 # " %# 11 #1 ( #34

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    74/829

    . .6# ## I ! . ! # # 9 ; % 19) # #

    # ) ! 18 # ?,4I,4& #A@ ! F

    ' ! . #" # ' ! +2? ! # ! (N/ # % % +3)"E+2 ! . #

    ! ! K3 "E FG3) " IH # %

    - ; # #4 # 1G? +3) 3)) " #D *%?" 2)) " 3 D ! " H %! " -N+ " " = : "? "

    )3N-) " # ## !

    + (# 4. # # 2))N-))) @E #

    I " ! . ! # ! # /3

    "E # G H # ! . G)+3 )3 \" H " )+3 \" I )3N+) \" I # +? 2?!(# G3)))) @ -+3 " H I ! " 3)))) @ I " +3)))N-))))) @ I # 2? /? ! %! ! . # % #

    ( )# !#4 !

    ! ! . # D # # ; ! - # I+2N2K; ! . I + ! ! .N # G 4"4'H ! . % # ! !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    75/829

    # " #$% K3P # # D -P *: ! # % # #

    % G- "E V)(+ H " ()N23 "E "! # " # ! " # # " " "? A "

    % # " %D&?;%@ # "

    #D ! # " D D

    4 %!# # # # # %

    $ #4 " ##

    G 4+H " # ! ! %

    # G -+H

    9 #- ! # /))N

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    76/829

    A 7( / 4$ !

    # 2 ! ! ! !" "

    *%

    # ! !

    4 %!# # # # % # /)!#GJ- "ED # # # " ! # .4$ H

    # ;! " .4$ ! ! !#G-)N+3 "EH

    F # # # G-H " G+H ! . # G(H $> ^? :8 " *: ! %

    $ #4" # ! -"E # # " >"

    # F ; #

    9 4 #

    ! *% -))"E " %! : ; "" +3G;H.("" ! .

    #

    #- !#G-)N+3 "EH

    I % " # )3N-) " #N >? G+3) " 5 *I

    H >? 4 G+3) " -2 *I H # ! : ? GK-3 " (( *I E3 H ! " : I "? # D /2?" #

    >? ! - " ! +3) " E53 #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    77/829

    A " ;

    + /) !#GJ- "EH I = (

    1 # B+ ! % ?%" =

    G-3 *I H G-( *I H $ ))KN)-/ E" G +3N3) "E"H 3)) )23P "! ! ! / # : # #

    ! # I/ = #

    ! " -3 "E # 9 +2N(/ # I *% # ! ?

    = # "! # ; I

    " # G! I & - V (- " D - " V ))(+ H

    #

    # $% /)P # " # -P *: " ! # " 9 " # " # ## )! "

    ! > -(N++ *IE

    4 %!## "?" %! " = "

    $ #4" " ! " 2 *IE > # % " " D #D " R R !D #D ;

    9 !4;" # ! # !" " $ "I !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    78/829

    " # -)P " -)N+) =G-N+ "H ! -) "F " ! " ! # ! I ! #

    ! )

    "# " %" F *7 # " R ! $ ! "%

    9 4" # # 4+ " " # " " ;! " " " ! ! % # " "

    " ! # " ! " % + *IE " " %!

    !4 % " % " "

    ;! " # "! % # "- !## # +2) "

    " IN# " % "?%2)) G+2) " " 2))?" #H @?" GK2

    " " -2)?" #H A

    + /) !## !## # -N+ "" G2 *IEH = ! -3 # / " " - = ! +2 9 # (N5 " # I+2

    A " ! +3*IE % # I %"" " I " # ! G ! I

    " & - V + *I V +2 "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    79/829

    "H

    +65 1

    *: L;XM 2) E G; 52)H " # ?# # I "

    ;X ;(N ! ' "

    % - E" ;X # ?"G H G" H

    ! ;X# # % G ; (N

    "H $?# " & G-H #" # *: G; (

    NH

    : G " " H # F "

    ;

    X

    G+H " ! ! # % G+H G(H " ;X% *: L;(

    NM

    # % ;(N# " ; (

    N

    # G; +2NH >;2

    X% A !

    " ; X #

    " >;2X%

    4 + 1 ?+52@4> $97 ! ; 52) _ ))( GL;XM 2)_ ( EHD + 2) _ 3 ;"D L;(NM +2 _ 2 E

    # # ;?;# I&

    % K '4 L ?C%;6DA4 3 ;@

    # ; I&

    C%LD K $ 3 ?;AC%;6D@

    : ! )- E ; E! L;XM # )K &

    % '4,

    C%LD '

    % '40C%LD &

    % *4C%LD

    % *4C%LD ,

    % *4

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    80/829

    C%LD '

    % *4C%LD &

    % *4$C%LD $

    % *4&C%LD

    % *4'C%LD '

    % *4*

    C%LD

    % *4,C%LD '

    ! # #

    4 #! 61 14 ; #G" L;XM ;H L; (

    NM

    +

    =#G L;XM " ;H I

    L;(NM + G# (?+H

    L;XM $ L;XM %?# ?# #

    1 64*% ?#

    $ 1 L;(NM

    ;(N $ +

    ! !

    9 1 = F # L; (N

    M ;X ;(

    N" "

    + # ! !

    -! +G!

    !H ;X

    ! (N3 L; (NM

    . -! = ! + >; 2

    X

    % " L; (NM ;

    "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    81/829

    4 >

    $ # # ?+2@ #

    9 L4

    X

    M I! &

    +2 K C+LD6?C.6D L C%;D@

    $7 -+ _ + E " # $7 " # G #H $ " $7 " " ! " G (454H $ $7 # # *: !

    $7 # G9N NH % !

    G "# 7H

    9 # # #

    &

    # #! ?@ K 3 C+LD L CDA, L 5>A4,

    >F # #! ##A.J C+LD CD #A

    $ " " F " "" # ! $7 # G (454H $ = " " "

    +2 ?>+2 @ !" $7 # G (454H @$7 # A &

    >+2 K ?C+LD L CBLD@ 6 C6D

    9 >;2X A "! @$7

    " >;2X% ! ! @$7 " >; 2

    X

    % >;2X ?N

    " G@7H >; 2X

    . >;2 # &

    >;2 K #! 6

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    82/829

    3 ?C+LD L CBLD@ 6 CDA, 6 5>A4,

    >F > #! ##A.J CD C5>D #A

    @7 # G"

    #?%#H " >; 2XB

    L>;2XM "

    (4 1

    $ 4$ " %

    # # " " L; XM L;(NM

    ! # $7 G 4+H

    $7 # "" ; (N

    " ;X

    # " @$7 @7 # >;2

    X% G 4 4H

    # !" $7 # G #?%#H " G 45H " $7 " L; (

    NM G.E.H % -&- .E.

    -&- % " $7 # # ! .E. " -&- "" #

    9 ! #- +2

    B ! ? # #

    " ! B+ # +++ = # G#?"H !" *: ! " # " "

    $7 # " # I LMG "EHE2/ " %

    9 #?%# G$H ! % # ! % ( E " *: ! # ! ; " -+N+2

    # . ! F %" % ! % # % " !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    83/829

    G # H ; # % "F F# % ! !"

    " # " .?N" # ?#

    ! % $"

    - $7 7: #+)N() E G -+H $7 " $7

    ;(N#

    >;2X%

    3 "

    $7 # " " $7 # " % # # # ! " ! ." # +/

    + # +2 - %;

    I % G +H $ %

    # ;(N# " % $

    # G:8 H "

    G " '8 H % G! H

    G A`"8 ! H F9 G H + $ ;! " # " >; (!

    "## L;(NM &

    ; " 5) % ; (N" -3P % ; (

    N #

    " " &

    " 3 C%;6D K 3 C%;6D 3 # # C%;6D 3

    " " G-)N-3 E"EH I

    7 ;(N $ F "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    84/829

    F # % # ; (N

    # # " *: !

    # %$L3G"! @$7 E " @7H # "" # "& 7 ;(

    N "

    " ; >;2 "?; "

    % G" # # H 7 ;(

    N #

    ! G" " # H G H " " 7 # # # "

    # %$L3 $ G! @$7 E @7

    J-)) E"H " "

    L>;(M

    G ; J3(H ; X G ; S3KH; ! # - G

    H 2 GH $ " L4 XM;! " " # " $ L>; (M

    # "G H ! # G" ""#

    " #H ; X G-H ;X !G H G+H !"

    " ;X G 454$H G(H

    #? ;X # # G" 9H $ # !" " GH # ;(

    N G -N+ E"EH

    >;( ; #

    #

    G 4H 4X G2)N/)EH # 4% # G -))N+)) " IH #

    # 8 %; $7

    # " ! ; 5+)

    L;(N

    M # % 3 E + +) ;" ;(

    N !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    85/829

    # 3)P # " ; (N#

    ! % -))P #" ! ! # >; (

    # ! >;(

    8 >;(

    # # # ! "

    (4 1 =

    $ !4$ L;(NM #

    ;(N" G;XH *: !

    ;(N # # N >X"

    " N !" G "

    ! N?" H GF H *: ! 4X : >; 2

    X

    % G ;(N"H #

    *: ! ### G #H 98

    "+X *%" >; (

    # " G" H ? # ;(

    N% I #

    7: # ; (N#

    G ! " ! H # #

    % G "

    ?" H9 #" " " # G!"H

    " GH % 9 *: ! # !" *:

    !

    ! % *: ! " " " #

    !" $ LNM GJ+) EH *: !"" !" !" G; S5)H " 47 G 4H

    L>XM " +) E L>XM LNM # " +) E GH ' *: !

    L> XM LNM " +) E " 47 ! %

    # # " " " > 4 " *: ! # "!" > 4 #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    86/829

    4X # # %

    % ! 4 X "+X % *: !

    > # F ! 4 X "+X

    # # "

    4X?" G H $F

    ## # 4 X # # " # L;(

    NM : ! G; S55)H *: ! %

    # # G-3) EH ; ! ! G)#53&-

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    87/829

    " H " "M G(H G # #H G2H ! # G # (?+H % ?# #

    9 #4# " " # "

    >%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    88/829

    '" () *

    $ %!

    $#

    ). ! # !

    7 " >" " ! " $

    $A "

    / ; ' ! ;!

    $

    "

    )

    ; 9 ! ! " " " ! ! #" # " G# 2?-H; F # 9 " -2)E

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    89/829

    # # H # 9 "! ; # " # " +-)E-+) ;" #" " " # " # ## ! ! #

    # % ! # ! $ #

    G8 "H # ; # 9 " # 8 !" 9 # " " " # 9" " # ! G-H Z? [G 9 !H G+H "

    9 G-()N-(< ;" K3NK< ;" H " "" G(H ! # Z" [ G2H

    ; 8 !" 9 " -2) ;" "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    90/829

    " ! A" ! I " " # #

    4 .1! )4$ " ! ! #

    " " *7 :" " ! # # # # " " " ! # " ! $ ! G=;H #" # !

    4 2 4 " ! "? I G " " "H 9" !

    " # "! ! 9 ! ! (N/ # "" " 9 -2)E

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    91/829

    9 ! " -K)E--) ;" I I ! ? # I ! !" 9 +))E-+) " I ?" " IF

    . %!) ! " " G H ! !

    ! 9 # !! ! ! # ! 9 ! # !# " ! - %!) # 9

    9 " -+)N-() ;" % -P ! ;! " G

    ! " ( "! ?" " !! H 9 ! G -35&+2-+ -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    92/829

    # ! ?" " G%FH ! ! G$+K(&-E4E+ ! " G S+3 "EH ?"" # ! #" ?" " #

    >X

    # # >X ?" " D # F

    ( / ! # F # " G ? " !H " FF? # # # F G"F -+3N+3) "EH

    # " !# % G H D " # # G # FH # " @ F ?"

    ! 9 /!#!

    - 16+ G # 2?(H ! !" " ! # !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    93/829

    ;: " !" " " ! G H=; ! #?" " # # ;:D ! #

    # !" G )/ ; : 44H

    ## #?" " !# #?" " " # ! 9 #?$" "

    ! " ! ! >? !

    # 16 # #! ! #

    -

    ?#"

    ! #-? #+?#" $

    ! " # "! #! # ! $ " " #-!

    #?$"" # "F " # " ! G$H#?$" " $ #

    / "?" ! # ;: 8

    #?" " ! " > "

    " #?$" " ! D "

    "? G;.H ! ! #?" " # " #?" " $ !#?" " $ ;. " 9 #?

    " # " " 9

    ## " G - / $23&/(5 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    94/829

    FF ? ! -?" " !

    # " " ! ";. ! $ " ! "!

    # F #?" "G / $-+-&-()5 -

    ! $ # # " " " #

    # / #

    " % +)P " ;: ! # G$'H ! 9 G

    H ! # G#8H +3P # " ! " # !

    I " ! $>$ % -)P

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    95/829

    ! "# ! D # 7#F " ! " " !

    3 ; !#!G " "H "

    G # 2?(H " ! ! "!# " " ? ?

    # " ## " #

    " > #" #" " "

    ! # " #" # % 7

    " # !

    # / ! %+P 7 ! #

    " ! " %

    !" " # 7 A

    # G # 2?(H ! " 7 ! # #

    ! ! " > # " % ?" " # ! G$+52&/+) -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    96/829

    # G" D$% H = F # # ;: !

    ( / !

    .F . ?% "

    " ! " " " " # " # # # ! ;: G 3H $

    N? # GH # "

    G& $ ((K&/23 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    97/829

    " !" ?"

    + +6 ?+-5@ ! " ! ! G& $ ((2&-/2

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    98/829

    ! ! ! ! " " " # # 9 # # " !" # @ " ? # !# $"

    " ! " " # ! " G 42HD "

    # !F " # "

    1 $6$4! ! "

    - /# ?" ! ! " ! " G # 2?2H

    9 # ! # ! ! %"" ! 2KN5+ " ! % # %

    # ! F ! # -) "E "

    GS+N( "E"EH ! ! 2KN5+ !" ! # 3N5 ; # !"

    FF % ; # " > # ! "

    + !"! = G # 2?2H # ! ! ! " " # " # !# " %" # ! ! 9 "

    >" # ! ! "!

    ( .1 # G # 2?2H ! ! " ! " " " '"! ! #?" " " ?" " >!

    = D #

    # # # " "% G"

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    99/829

    # ""H $ ? # 3NK =# " # # = = # # # #" ' 9#" " # +)) " /N-+ # +))N2)) " " 9

    2 # ?" ! #?"" G # 2?2H #

    ! " #?# * #?$" " # ! ! I # " G"

    H3 ! = " G #

    2?2H ! ! " % ! > # ! ! = # " I-+ : () #

    ! 2K / ! ? G # 2?2H

    ! * G $* #H # ! ! " ;! !# # ! # $* # 9 ! " !

    ! # # ! " # " = "

    5 :3 !: # #! ! !" " 4"44 4"44 4"44 4"4$4 4"4&4 4"4'4 # ! F " "? ! " # #

    7 ; !) #

    ! " # 9 - ; ! # " )+ "

    # )- " I- )5 " +) ;" 9 # -3? ! ! ()? ! ! $ / # K? " ! # #" ! "

    + /1 () #

    %! # 5 ) ) )

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    100/829

    ?=A@ 1 1 )! ## ) 5 G -)5&-K3 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    101/829

    $* # # # " # ! ! # ! G& $ (2+&-23 +)))H : $* # ! " G& $ ((K&/23 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    102/829

    ! # F % " # # " " #! "! !

    (4 !4 #?" " " $* # $9 ?" " " ? " . "? ! ! #! # F #?" "D " # ! ? " # G

    " ! H 8 G " H " " $* # ! # 9

    " #! #?" " " " # A " - " + I 9 "?" " # # % " " ;: =; # " # " # 9 "! "D " 9 " # ! $ ! " " # " ! # ! " # 9 A! -N(

    (4 + !4' " " # " ? " $ # " ! " "

    ! ! # ? " !#

    (4 +9# #4 " # I " !" # #" " " G

    ? " H " # # ! " @# " # *%! # ! # ! !" # I " #

    /

    4 %! 8 88 !#4;

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    103/829

    # ! " " " # 9 # # !

    $ !### G"

    H " % " # ; # ?" F ! " " # ! G # 2?(H #?$" " # !

    ?" ! %#

    9 # 3 1 " %

    ! " ?" # ! " # # " > # ! # ! % # G #2?2H

    4 8 !# 8 !) !4 #" ! # " ! ! %! 9

    $' ! +2N5+ 9 ! " # !

    ! $' $' "" " G H #?" " # # " " 9 # # " " #

    ! ! #

    . ! # ?%" #! " $' # ! " " ! G # 2?(H ! " I ! " $' #

    #?" " # # ?" ! # " %# ;! # G # 2?(H #

    4 %!) G 4H

    ! " "" ?" "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    104/829

    # ! 9 9 " " # # G - H " $ # " +)N+3P -))N--) ;"! $ 9

    ! !" ! " # ! # 9 !

    " # " " # ! 9 -))N--) ;" *%! 9 # ! F # > 9 # " ! ! # !

    (4 + 4$ % G $H "" G 9H #

    $ " " I ! ! #F ! G" H # 9 # -()N-2) ;" $! " "! " " #?"" "

    $ /# " # # # % #

    ! 9 -))N-+) ;" # 9 I " > ! #I "

    # "" " I 16 !

    " # # != #?" " ! ## ! #" "?" #?" "

    # 9 ( 1 # " "

    G$+3K&5K -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    105/829

    (4 ! !4; " " # #

    ! 9 ? # " !

    ! ! #

    $ !" " # # $ " # 7" G& $ ((3&+35-

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    106/829

    '" () *

    & # %

    $ 7#"

    #! )7 $.

    /1 +.""

    >1 + I/6) ! @$."

    $ "

    !F/6) !

    ." $ "$

    /1

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    107/829

    # " # > $ G$.H #" G$H G;:H

    +/ 1 ?>+@ I/6)#! ?@ /6) 49 N?! ZNR?! [ ?! ZR?! [ ;! "F R ! ! ! " *7

    ! " *7 $ I " """

    # ;! # # %" @$ N?!

    # ! ?! # # 9 ! *7 " # " G # 3?(H

    1 &64 " GH

    #! )

    4 2 4$% +2P 2+P $. +5 # # $. ! $. " #

    4 -= + " " # $. " " $.

    4 -= #

    $ #= $. ' ( " $. ! G$ % !22&-+25 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    108/829

    $. # +3N/)P $. # ()P G& $ (2-&2K

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    109/829

    # " # " " $. !! "

    + 3 2 #" " $. " *%

    K3P % " ! G53PH # % " *7

    # G" "% #?" "H! % *7 $ ! ! ! $. "& G-H ?" " - % G+H ?" "

    + G(H # % + G2H 9 % G3H ! ;:

    ! % G/H "! % GS3 H # ?" " # ! ! " F ! !F $. # 5

    9 % ! " ?" %

    " ( / #! # +)-

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    110/829

    5)P " "" ## " % " " " #! "" ! " # # "# " =

    "" "? @$ %?

    #

    4 #

    $ 2 4 " " " % " !" %" " %"

    " " G" H %# G%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    111/829

    ! $ " # -!

    $" ! ! ! "

    # # ! " 3)N/) #E G#H %

    % " " # 3? ! # # G" " H " " " " " " # # ! / # ! " " # """

    ! " " "

    I " # # .6 "? "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    112/829

    " #?"" #?3? " #!# " ? # " # # ! I-+ $ ?

    #?3? ? " # # -+? ?

    ! ! ! T ! -? +?

    I2N/ # ! " % () >" # "?" #

    # !/6 # !

    # ? G+3N3) "E+2 H ! " # "? # ! -+ F !

    " ?

    ! -)N-+ ' # ! " # I

    2 # ! " ! ! $

    " ! "! # # " ;: !# " " # #?" " " # " @$ G 2 # 2?(H 9 " ! ! ! GF8 "H G = =$"H ?"

    !" ! F $"

    "! ! ! " 9 $= # # = ;: #%# ##6 1 ) 8 + >+ 1 1 3 ) #1! #!4@ #?" " F% ?

    # # @$

    # :# ! " $= "!

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    113/829

    ! (# !" $=

    " "! F " " = =

    $= ;: # #?" "

    # $= # = "% !

    /6 !! # G 2# 2?(H "

    ! 9 $= # ! #

    $ $. ! !" ;: G& $ ((3&--)5 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    114/829

    F # # # # # ? #G @# $" >N?*! 4+H " G7H #E "

    # G%-))&+)23 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    115/829

    % " ? " $ # " " $ ! G & $ (2+&-)- +)))H @$ # ! % ;:

    4 -= 8 >+4 ! @$ -)N+)P " D " 3N5P " " " " " G # ??!" *7H ! =

    "" " %! "" ! ! ?"

    ! ?! ! # "" ! " $.

    4 4 @$ N?! #" # *7 " "" " $% 53P @$ N?! # ! # *7 # # ?!! I ! I/6)

    # ! F G9?4H ! ? ! # ! % 2)P # G $+K-&5)5- # "! = # /)NK)E" # -2 E"E ! # GH # I/ ! ! ! G " ! " " H .86#68 G% - "E" #H ! =

    G& $ ((5&225 -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    116/829

    " 3N5 ())))N3)))) G$ % %(-&-22

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    117/829

    ! " # # ? " > " # #?" " @$ @ # ! !# # #

    > " ! ""!

    . "1! # @$ N?! ! ! ! 999 " @$ N?! G%K

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    118/829

    4 I " &G-H " " I! G+H *7 "

    G(H ! F

    $ %!4 # " # ! " ! # " $" !" " ! # ! # %# ;: # G # 3?(H

    9 ! 3#4 % # " # " >

    """ "" I !

    4 "? ? #" # % ! " G4 H ! % " G J3PH " " (" G4 H

    # " G4 H !

    %! = "" I ""!" ! G4 =H! K)P #" " ! "F

    ! A" ! ! ". 24*7 # # "

    F # ! $" % ! *7 A " *7 "? # " ! ! -

    =2 "" " ! G=H

    - /668) 4!% ?" ! " ! ! ! A " ?!

    + G 8)4 ! R ! GS2) H " " # "

    ( 2 ## G # 3?(H ?" ! ! R ! G H ?% #! #

    * :!#4 ! ! F "! !!

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    119/829

    - 6 4$ ? GH GH ! ! " ! A 9?4 #I ? ! 9?4 !

    ! G& $ ((3&-((( -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    120/829

    7 ! ! )!4 I ! " # " *7 "

    4 + ##4 " " ?! ?! ! ! # " ! ! %" "F ?" G$ % %(2&K

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    121/829

    # " A

    . 16+ F $ " # ! "& G-H ! ? " G+H

    /) # G(H 9 !" # "

    7 ;3! +N2 E ! # % # % %" # / $ # " # # # "%" ! #

    9 !

    ! #" %"

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    122/829

    ; 266# ?2B@4# $ #! " "? 74 G+3P " 3) @E K)E 4 -3 E"E +2 H ? 74 G-)P " +)@E 3) E 4 -) E"E +2 H ! " # ! ;:

    ! # 74 G%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    123/829

    ! " # % )5P # "" 5) " ! G9 S-K)E--) ;"H ! # #

    !F # ! #"

    # # $

    1 &6&4 # + / 1! G# 3?/H

    1 &6'4. # " -#1 6# )G ?$H

    ! " ?$ = # -3 " # = )53 "E" G 3) "H ! () )3"E" G (3 "H # = ! /) # " 5) " ! % -)) " !

    4?$H " " !

    # # " "?! #?- ""?# ' >4?$ F G ,(32&5-/-4?$ ?$

    ( 1! # " #

    $

    %! " "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    124/829

    " # # -) ! ! -))) G & $ (+

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    125/829

    999 " " () -+ $ -+ *7 " $ "

    # " $ # #

    " ! " !$97 # " $ # # # $ " 2K # # ?9)@ +

    ?" !

    + +9 +4$A! "" ? # + $

    " # "! (+3 "

    N? G 45H# % " $ # +2N2K

    "! 7 #E# " # G " !" " H

    6 1 # # $

    !

    ! # " $ !" N? G(+3 " IH G+3) " #H "G53 " IH - # $ # -/)N(+3 " ? E

    . #! +524. " " " $97 # ! # $ *"$97 "

    # $ ! $ G (H ?# #F # "

    /1

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    126/829

    +2N(/ !F

    4 +)! )4# ! # !" -+

    ' # ?! ! " #" " # ! =! ! ! $ +2N2K # "! ! !

    4 18 4 # D # # I # ! -+))? -K))? " # "

    #!" 9 # %! "!

    4 /4> ! # % " * ! % #F" !" !" #

    #FF # %" " @ # = " R ! G -H

    (4 + # !4#I " # ## " F !# " ! " " ! "

    $ + !4 -/) " $" ! # @ : ." $ " ! " # G @# $" >N?*! 4+H

    9 + !4; # "! ! # " "" $

    " ! ! ## ;! !" # #I = # ! G ?*! 4H " # L" " # G$:H ! # = #M #

    = " ! G F I H ' # $: !

    = ! # ! (N/ = # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    127/829

    # 3))) # #

    +6) :!# ?+@1! ? +2 ! " # "? "

    " ;: ! ;! !"? ! = ;: ! #

    ! " G& $ (2+&-23 +)))H $* # # ! # G 2H = # !

    " # # 9 %! ;: =

    GA J2)PH ! $* # . 16+ # ! G

    ! 45H* 4$" # #

    % #

    " # ;:

    : # ! # ! # ##6 1 8 3 #! 4 ? ! ?! F N?! "" "

    = #?" " .F # =

    7 !

    (4 -= ): 1

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    128/829

    ? % " -)N-2 $! # #% % " 2G# "H % " +N( # " *7 G" 999 = # H " % "" %

    " ! ! # I!

    9 ! # % # " "" #" # # " !F

    (4 -1

    $ 6 4 ! # "! ! # G H 9 #"# #" # 9" ! !# " ! !! " " #

    9 ; 49 #"" # +)N() " +) # " 9 " "!" " % !

    ? G (45H A # K? -+? # " #

    ! " G !H

    # !

    4 - # # # # ! # *7 ! ? ?!" ! F ! # % *" " "" #

    $ - #4 +)N()P # " ? !

    " #?" " ?# # #F"

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    129/829

    "" # # $ $97

    9 - 4*% 3N+)P # *7 " #

    ! # ?! F! #

    ! # # $ # # ! # +2 #" ?$ ?$ 9 ## ;: #

    ? % # ! !F

    + 4 ! %-3N+3P " # # ! %# # #" ! ! # " $ # # # !

    ! " # ! "

    *7 " # # # C? !! ! " ?! " $/3) " I/ " N?" ? " G>$.H

    " " # " #" = ! " ! # # " " %" " " " #

    . 6 ?S@ !##! # ! F # ! ! ! ! # !

    ! # # " *7 ?" ! # # " I %# !" >$. G/3) " I/NKH G+3N3) " I/NKH7 G- "E" IH # I ! D # " F %# $" #

    # " )

    ? #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    130/829

    4 +!# $" ?" ! G=H # G=:H

    #!" "

    ;: # ! %#" # " ! "% # G "H ;: # "

    $ ( !#G 5 KH- ( # :

    ! F " #

    # #?""

    + + ) !# +)P + ! #" " 2K I ' ! # !! " ! G 5 KH

    ( ## !# ( " 2K I GS() H

    / ( 2K ? = ? "? ." " +2

    = I ! G 5H

    2 #! (" # 3P F 2 =: F #G KH =: GS2K H I ! G 5H

    9 /) !G 5H- / ! I

    ;: % % ! ! ! " ! " !! ! " " # ;: #" ! # A

    #?" "

    + 3!# ) ! I # # ! %#

    G 5H( +" # !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    131/829

    # ! " $: I I" # /

    2 7 !#

    $= A G ()N/) #H A G 5)N-() #H $= A

    #" # I ! $= " $ A G% AH # " % G 5H

    5! 1=- / 1! I

    " ! # G 5H

    + +( 1" ?" ?" ?" GH $= #

    "6 +( 1= # "% " $=

    # /6 +( 1= 1: ! ?=1@ 1: ! # # ; " #F $= # ! " # #

    # #F # " $= # I " G 4"H

    6 1= $= ! $=# ! # # ?" $=# ! # " " # # # ? ?" $= # A ! > ?" $= # "

    I " ! " # " G 5H

    . ) 1 -)P !! ;?A "? G-H # " # # G999H G$:9H G:9HD G+H # # !! # # # 999 $:9 :9D G(H # # #

    ?" $= # > I # #

    " " ! # I

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    132/829

    ! " G 4" 42H* +! ! ! $=

    # % # $ ! -3P " ! G KH

    : #! ) G-H G+H ?" $= # G(H #F ?" $=

    # G2H # #F ?" $= # G3H "? # G/H " # # #G999 " 999D 999 " $:9 :9H G5H?" $= # " # "

    ! G$= I "H GKH = G!!"H

    7 !# # ! " " ! # GH ? !" G-H "?# # ! G+H "?

    999 G(H #F ?" $= # # G2H "? ?" $= #

    # G 999 $:9 :9H

    4 %! ! %" F % " " #

    ?" # = " # " I " ! 9

    $ 16+ %

    # #" G ?*! 4D 2H

    9 + 1 # #?" " # G #I "

    (4D 2H # # $* #

    #?" " ! 7! # ? ! F # # # # G #I" (4"D 2H

    . ! G$% . 2H

    * ! # "! ! = " #

    = " ! " " !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    133/829

    ;: G$% .H

    (4 .( = G !H !

    % $ "" ! %# " !! " ! # ! ! G /H

    $ # # %"4 " (

    " ! # !! "= !! # # "- " # # #

    ! ! G /H

    + " #" =" 9 # -)N-3P # #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    134/829

    - %!)# !4. = " L ! G$H J-3N-K ;"M #

    % GJ+3 EE +H " # # 9 =

    $ -3N-K ;" " !

    + #! 4$ ! = " G$ S-K

    ;"H % GS+3 EE+H ! ! = = " # " #

    ! ! ! #

    ( !4 # ! = "

    G$ S-K ;"H % GJ+3 EE+H

    " -)) ;" " = 9 9 = " G$% .H >" # ! # " " # ! # -)))

    EEN3 = " # $* # " ! > !# " # @

    # ! ! " 9 % ! ! " # #

    2 =4*! = " G$ S-K ;"H

    % GJ+3 EE+H -)) ;" %! = " 9

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    135/829

    ! %" % # ? # $ # ! "# ! "" ! G (H

    3 -(4= F # % GJ+3EE+H = " !" GS-) ;"H ! " # ! =

    " ! A" ! ! 48 " G A"

    ! H "? " " *7 ## F ! = 2

    = *" " !

    " " =; " ! " ! "? ! 9 $. # ! # " "

    9 + # "- 4 "

    "" ! ' ! "" ! " ! "" " ? " . ""

    " " " ! "" ""

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    136/829

    + #4 "" # " !! " " =" .# # # # ! ! ""? # #F

    *" " # #

    " 53P +2 - ) #4 ! -N(P

    - 4= "" # !

    " # " #

    ? " . "" # ! " ! # # " 3P ? "# %" # " " ! " " F

    + #4

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    137/829

    " " = # # "

    : ( !#4: = # % "

    # = # " #"" "

    ?" ! *7 ! # " # = I " # ;: ! #F

    / #

    4 4 #A! ! # " " I! # ! #I ! +3P ?" " $. % 3)P " G $ % %+2&- -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    138/829

    # "* ! # # " " ! #! #

    4 4 ?" ! " ! $# *7 " " "" ! % " $. " # # " " " ! !! " G= "! H

    4 # ! #" " > G-) "H

    # # "?" " I "? F8 "" " # $97 $ # " % #

    /! )

    ! ""! #

    " $. # " ! # #F $ ! " ! " " $. : % $. # ()P G& $ ((

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    139/829

    -)H 3 #4" # % #

    " #% ?

    . 3 # 4 ?%"

    " ? # " #

    #?" " $* # # " D F # # "

    4 !4" ! F " ! # F !

    $ + ! $G53N(+3 "EH " # # ? " # # ? $: ! = " = # # ? (N/ # " F +)N() # !

    # I " # ! " "

    9 16+ ! !

    " # G -)) " #D -)) " ID -) " #D K) " H #?$" " ! # ! ! G 2 # 2?(H ! # ?

    + 1 ;: = A 2)P

    "? = ? ! $*# 7! " "? = # $* # " G& $

    (2+&-23 +)))H. .68 #

    G ; ; . H* - " !

    # G;H ! #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    140/829

    ! " G$+K)&/)3- * " #" " ! " # ! G $+/

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    141/829

    /

    + 1 .. ! -)) "E ! ! # ""!

    9 /) #! # G:;H # G:;H # " - "% !! .

    %:! :; ! 3)P # .

    ! .? ! ! (3)N33)"E % - 3)) $

    ! ! ! % I "

    # ?" # .?

    # %#:! :; ! . ! ! .? ! # ! /3)N-))) "E - - ; #" $ ! # % " " ! " ;7?$ # .?

    ! #

    "# ) 56 # # .? #" " 9?-)) A . ! I ! :; F"

    + "%. ! ! ! " # # D ! =. :; -N+P " # : #

    ! ! =. ! .? ! =. .? I " " # " %

    ( /) ! !# .? #! ++) "E "

    2 %!!# # # %

    # #?" " " ! "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    142/829

    " ! " 2)) "E " " # :; "

    3 !1#G H G% - 3)))H # #

    * =. #

    ? =. G#?=.H " " ! ." # # " " # * ! #! % !

    " / %!!## #

    :; #$" " " " # "

    5 .8 %.6 ) (3 "E # # "

    #! " ?

    " ?? # /! ;.? ! " "

    # % " " "# #?" " "

    /! !# # ! F #?"" G ! H " "" # ! !# " ;. # " # " # " # !

    4 #

    $ 8 ! ) ! ) ..6

    ) #A 4 #" "F ! #" # +> * " 5P +)) "

    " " ! " "

    9 ! # F ! ! "

    - .. # ;7?$ #GH& ! ! ! ! !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    143/829

    !D # I D G H %26+ 1 .

    " " . ! . # +)N/)P "

    " " $ $! " ?

    % -( # !?! % +N( # "! " ! # "! !" D ! ! ! ! # # !" /

    I G% 3P H #" " "

    - .) # ! / ( ! / $% -P ! ! " #

    + !! I # #

    # # "#F

    # 5

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    144/829

    # # ( ()) " # " " ())) "E " # "

    %D ! # ! $ ?

    %? # "! #D" ! % +))) "E % +)))"E

    + +) 4 /# )66 6 ) 1 8 ) ) 3!J N? #

    :" # # " # !" @ # " # ! /NK " > # !

    " ! ! #

    + %!!# # # !! # ! " ! . 2#1: 1 # !!

    !# @ "#F /)) "

    # # " ! # ()N3)P " # ! $# " !" # !! # ! # " "#F # "#F :# !# /5? -(2? +))?" " /5 "E I +)) "ED ! # # "!

    3N-)P 7 I % 3P " I " 4 ! # "" # # # ! ! .? ! " "

    # # "

    # # ! #

    " % " "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    145/829

    # % # ! " " ! ! "" ." " F # " " " "

    " ! !" ;; 1 ) 8# 8

    ! ) 1) & #A4 8 ! $ #A !

    .? ! I " ! 1) $ #A I %

    " "#F# : ! ) #A

    # " .? ! " " # #

    ( .8 %.6 ) ! $ # "!

    ;. " " "#?" " " "

    >" % " " # > ! " " ;. G% -)N+)PH #

    >%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    146/829

    '" () *

    ' % " #!! ()

    %

    7" $ * C 7 "% "

    " 7 " ;:

    $ ;: " G*H

    #!!. ;

    ! !

    () % $$

    % "

    4

    $ 4 % ?%"@ # I # # " % " #

    9 !4;: # # G H ! % " G H G#/?-H ; I

    ;: @ $ " # !! ;"? ;: ! ! % ##

    1 '64 !!4;: " I

    %" !

    ! ! " $ ! Z [ " G-H ! G=H

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    147/829

    ! GH GH G+H ! G=H ! ! ! ! " G(H ! ?" ! G H A

    " ;:. # ;: ! "

    " " " # / !## " % *% ! = ! " G H # G "H

    " *! = !

    ! " %% ! A" ! " $ # # ! ! 9@> ! ! F

    * %" # # " ! " ! #

    . ! # #" !" F !" $# *7 ! ! ? "

    : ;: " ! ! % G %#H " G #?"" ? " "H #

    4 2 ## %"

    $ ;: # !F " ! " %"

    " " " " # G"

    H # L" ! G$HM $ # # % " ! ! # # # " # ! ! %

    ! 7 " F F ! "

    " ! " "" ;:

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    148/829

    9 # #" A " - - ! )! # ;:

    %" ;: $ #F " # #

    % ! ;:G%K3&+--

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    149/829

    L" GH "" GH =M = ! #$" ! ! " # = # ! # " = "

    ! " !! ""

    ! ;: ! = ;: # ! % ! ! ! ; F ! "

    ! " = # % L" $

    G;HM G! ;H ; ) #

    ;: ! #" ' ! #"

    " ?- +6) :!# ?+@ 1G# /?+H

    ! ! " ## ! ?" $*# ! " = " " 9

    " ! $* #! !! ! ;:$* # ! ! ;: = ; ! $* # " !" " ! %$# # $*# "? # $ # $ ! "

    " " ! # # " # ?" # " $* # $* # % # " "D " " # $*

    # " !

    " -3 "E

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    150/829

    1 '64$"?!" F # T+ + 1= ?+-5@G# /?(H #

    ?" ! # "

    $* # # ! # # !

    " ! # !# ;: G%

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    151/829

    " ! # ! !! ;: %F # # " ;: ! %F ? G$+K(&-

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    152/829

    " #?$" " # ! ;: # ;: % ! A % #?"" +N( I #!

    " ! # #"?" G$+K(&-+ , ; $ = ;:

    F ;: G ,(3(&

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    153/829

    # # #

    " ! ."% " # "!" )+3N)3) " = #)+3 " I/ -)N-3 "

    # 8 " # " )-+3N)(53 " #

    ? ((N22 $ "% ! " ."% ! )KN+) "E" # % "

    # 8 3

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    154/829

    # "D # ! ! # ! D I # # ! ! G 5H

    ! " " ! #

    %( 36 "1 1! # !

    !" ?" "% % # I."%? :# " %

    ! % # 3 ) # # "1 #J

    G#H "% # ! " I " ! ! # # " * 2)?" ! :# "F % )/ " "% ." # " " ? !

    G # +/?+ H3 G# /?2H A

    ! ;: ?" # ! !! F > ,; $ = ;: G & $ (2-&53( -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    155/829

    : # " ! ! "" ! ;: ;: #

    7 # # # I! = "! @

    # # % ! : # !! " ?! * " #

    #6 %

    # ! !! F

    ! ?" % " # D $* # ? " G S+3 "EH

    / /!### G$% .H

    ! ;: 9 ! # #?" ! " " %# ."? ! #

    # " # " # *7 "- # " % !

    ! -N( \"E"E! "? " ! # ! " +NK \"E"E

    #-?" $ " 5N-)

    \"E"E ?" D " ! = # ;: .

    # #F ! + 1# " !

    #-?" D #+? ? !

    " % !" "

    9 " %! =" ! ! .#

    -N+ \"E"E # %!

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    156/829

    ! # # %" I%! ;: # # # .#

    # # ! #

    "" # -) \"E"E # .# " ;:" G" ;H "?

    # 1G$% .H ! # "

    +# # !# ;: $ ## ! ! ! ! ! !

    ! $ ! "% #

    $ 53)?\"E" # = ! +N( # +3N-)) \"E"E # $ " 3) \"E" !-) # )(53N)53)

    \"E"E ! I # ! # G H

    . ! # ! ! ! - 6 1 #

    #! 9 " I # %"

    ! # $ " " ! ! !! ! ? #

    + ( )I " ! ;: " ! !# " !# ! ! " "

    " I

    ! ! # "

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    157/829

    % * !

    ?" # ""! ! !#- # " /3

    G" #H ! !;: G> , ; $ N=H ! "

    ! % # !# % " ! G$ % %++&- -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    158/829

    + # # %

    ! +N3 " = # "! ! ! # ! -)N+3

    # "# !

    " = # #" $ +)N2) " = # "! !

    ! # # % +)) " #I

    ! ! $ = # # #

    L 44414?@M ! A * *

    !! "" G =! ; . 4544H F # "

    # # # *

    G 4 44'H( + #! # !

    " 2 - :G" ?7F H #

    # " " !

    " #I G 3 (4

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    159/829

    " 9 4 " # "

    !" ? ." " ! !!

    *7 # # " * # !

    G/ $-+2&-+3- -=H " # " % ! ;: %

    " ;! " >= # ! !!

    "? ! # G& $ (+-&2)/ -

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    160/829

    ! ? # ! ! # #F # ! "

    4 % F # ! = ! ! % ; G H ! " !? " !# %! $ I

    $ ! ;

    ! G H # !! ! " I # " # = # = # # # = ! ! . ! % " %" ? !! # = #

    9 ! # "

    " # # " # " -) (3 "

    % " # G #H #

    F " # # ! G" =! !H

    # ""! ; # ?" . # #"

    " = " !. # !

    ! ! ! ! # # + ) 8 % ) ! )!" ! - !

    16+ ; # " @ " "? ! " -/)N(+) "E G

    I! #?" "H ;" #?" " #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    161/829

    " " % 2K)"E "

    # # )# :# ! ; # " ! " 9 !

    # ! = # #

    " # # " ! !

    ! "! ! ! G #

    "! !H " # ! =

    # # %! #

    ) 1 )# " = "

    + + ) !# ##!

    ; ! # ""!D !

    ! 3 )!# ! %#" ! # $ # #! # .F ! #?" " # !

    # ! G 5H # ! # >= # " ;! # " # # % !!" " # !?# # "? G & $ (2+&(/3 +)))H ! # 5

    ( 6#1 G 5H #

    " ; G%K3&+-2

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    162/829

    G=H

    4 -) #!! " # ! "" "

    #

    $ !! 4 # ! " !" " " " *" ! " !"" ! . " ! # " ! ! *7 !" !" !

    F ! ! = = " ?? = = " = # # " # " # 18 ) #!! ) # # " #! !

    9 #- 2 # A

    " "% =

    3 1 ) 8 #! # 8 # "% % ! # # # "

    # ! %! D! " # I I

    + / ! # # !

    1 4 # ! # % " #

    " !! # # > # ! !" "

    4 ) ! # " " #

    # " !

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    163/829

    !

    $ !! 4 ! " "! ! !

    " ! " % ! " " A" ! ^ , ! A" ! G48 "H " *" ! " "

    " F ! IF

    # ! " ! G 4+H

    9 ) #

  • 8/10/2019 Washington Manual of Medical Therapeutics 30

    164/829

    4 / # " ! "D

    " !! !

    % !! G # !!H #

    $ !!4" ! ! I " " ! ! # !! " ! " !! % ! "

    %# ;: " # # # " G+)PH #F "

    9 4 " " " ! " " ! ! $ " #" " ! # # ? . "" " G**H #

    " ! " " # F

    "