This care is particularly important when the recommended agent is a new or infrequently used drug. In view of ongoing research, occasional changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, however, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. The authors and publisher have exerted every effort to ensure that the drug selection and dosages set forth in this book are in accordance with current recommendations and practice at the time of publication. Printed in the United States of America Printed by Sheridan Books Composition by Scribe, Inc. No part of this publication may be reproduced in any form by any means (electronic, mechanical, xerographic, or other) or held in any information storage or retrieval systems without written permission from the College. Ripca Copyright © 2009 by the American College of Physicians. Nolan Editorial Coordinator: Angela Gabella Design: Michael E.
Kleinberg Senior Production Editor: Karen C. Alguire, MD, FACP DIRECTOR EDUCATION AND CAREER DEVELOPMENT AMERICAN COLLEGE OF PHYSICIANS EDITOR-IN-CHIEFĪssociate Publisher and Manager, Books Publishing: Tom Hartman Production Supervisor: Allan S. A MERICAN C OLLEGE OF P HYSICIANS C LERKSHIP D IRECTORS IN I NTERNAL M EDICINEĢ Patrick C.