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
Things Ain't What They Used to Be Things Ain't What They Used to Be "Things Ain't What They Used to Be" is a 1942 jazz standard with music by Mercer Ellington and lyrics by Ted Persons. In 1941 there was a strike against the American Society of Composers, Authors and Publishers, of which Duke Ellington was a member. Because of the strike he could not air his songs on the radio. Instead, he used songs written by his son Mercer and pianist Billy Strayhorn. Strayhorn's compositions of this time include "Take the 'A' Train", "Chelsea Bridge" and "Day Dream". Mercer wrote "Things Ain't What They Used to