Loperamide have negative effects from rebound constipation. If a suspicion exists of diarrhea associated with organisms that can penetrate the intestinal walls, such as or "Salmonella", loperamide is contraindicated as a primary treatment. Loperamide treatment is not used in symptomatic "C. difficile" infections, as it increases the risk of toxin retention and precipitation of toxic megacolon. Loperamide should be administered with caution to people with liver failure due to reduced first-pass metabolism. Additionally, caution should be used when treating people with advanced HIV, as cases of both viral and bacterial toxic megacolon have been reported. If abdominal distension is noted, therapy
What Is to Be Done? What Is to Be Done? What Is To Be Done? Burning Questions of Our Movement () is a political pamphlet written by the Russian revolutionary Vladimir Lenin (credited as N. Lenin) in 1901 and published in 1902. Lenin said that the article represented "a skeleton plan to be developed in greater detail in a pamphlet now in preparation for print". Its title is inspired by the novel of the same name by the 19th century Russian revolutionary Nikolai Chernyshevsky. In "What Is to Be Done?", Lenin argues that the working class will not spontaneously become political simply by fighting economic