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? (Tolstoy) the same Biblical reference (Luke 3:10–14). What Is to Be Done? (Tolstoy) What Is To Be Done? (sometimes translated as What Then Must We Do?) is a non-fiction work by Leo Tolstoy, in which Tolstoy describes the social conditions of Russia in his day. Tolstoy completed the book in 1886, and the first English language publication came in 1887 as What To Do?. A revised translation with the current title was published in 1899. The English title was also used for two better-known works by Nikolai Chernyshevsky and Vladimir Lenin; Tolstoy's Russian title is similar but not identical to Chernyshevsky's