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Seldom has there been a drug that has excited as much controversy as misoprostol. It is used in rich countries to prevent gastric ulcers, but in poor countries, it is increasingly given to women to prevent them bleeding to death in childbirth. Some people believe it is saving countless lives. Misoprostol causes the uterus to contract, which is why it can stop postpartum haemorrhage, the cause of around a quarter of maternal deaths. Finally last year, the World Health Organisation put misoprostol on its essential drugs list, which gave it the seal of approval. Pollock and her team say there is not enough evidence from studies that misoprostol works in preventing postpartum haemorrhage.

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The decision has been made: we are going to write a medical textbook and publish it both as a book and on the internet. Think back: how many doctors were familiar with the layout of letters on a typewriter 20 years ago? Better still: we are not only adept at word processing but have also become practised layout designers. Do we go to a traditional publishing house or is it more beneficial to produce the book in our own garage? There is sometimes a sense of shame at the idea of publishing a written text ourselves.

The concept of abortion is as old as pregnancy itself; women have desired to mifepristone and misoprostol buy online their fertility for as long as they have been able to get pregnant. In many other countries, however, people are able to walk into a local pharmacy and purchase abortion kits containing both mifepristone and misoprostol or Cytotec misoprostol over the counter to end their pregnancy. Online services, such as Women on Web, have also been shipping pills to those who need them for more than 10 years. Cytotec is an inexpensive medication that, in addition to being an abortifacient, is commonly prescribed to treat stomach ulcers and postpartum hemorrhage. In these countries, women are able to make this decision for themselves without involving a health care provider.

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All drugs in this group are toxic, common side effects being gastrointestinal disturbances, anorexia, pancreatitis and liver damage. Non-nucleoside reverse transcriptase inhibitors such as efavirenz and nevirapine are similar and have a similar profile of adverse effects. Viral protease is essential in retroviruses for the production of mature viral particles. Inhibition of the enzyme slows spread of virus from cell to cell because immature particles cannot infect host cells. There are now a number of protease inhibitors available; examples are indinavir and amprenavir.

The protein theory is thought most likely. All general anaesthetics cause reversible loss of consciousness, but they are also capable of depressing respiratory and cardiovascular centres in the brain and of depressing the cardiovascular system directly. This makes them potentially dangerous in use. Inhalation anaesthetics are gases or volatile liquids. Nitrous oxide and isoflurane are commonly used. Intravenous anaesthetics are used to induce general anaesthesia, followed by an inhalation anaesthetic for maintenance, and for short surgical procedures.

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