Are there any guidelines or recommendations regarding prescription drug use after bariatric surgery (either acutely or years out) for generalized medical care?—KIM RUTTER, PA-C, Franklin, Wis.

To my knowledge, no specific guidelines exist. It is clear, however, that hypertension and diabetes medications will have to be adjusted in many patients following bariatric surgery. Careful monitoring is especially important in the early postoperative period, when rapid weight changes may be most pronounced. It makes intuitive sense that other medications that are dosed according to weight (e.g., anticonvulsants and thyroxine), will need to be re-titrated as well.—Reuben W. Zimmerman, PA-C (138-1)