How do I install the Ata Post Acth Tumor Gc skill?

Run npx skillmds@latest add dromlakhani/ata-post-acth-tumor-gc in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

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Which AI agents work with Ata Post Acth Tumor Gc?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Ata Post Acth Tumor Gc free to use?

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Who published Ata Post Acth Tumor Gc?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Ata Post Acth Tumor Gc by dromlakhani

Name: Ata Post Acth Tumor Gc
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Ata Post Acth Tumor Gc

Recommend continuing glucocorticoid replacement until hypothalamic-pituitary-adrenal (HPA) axis recovery after surgical resection of ACTH-secreting pituitary tumors. Use when managing postoperative patients following ACTH-secreting tumor surgery to prevent adrenal insufficiency during HPA axis recovery.

dromlakhani Updated Aug 19, 2026 10 repo stars

File contents

Continue glucocorticoid replacement until HPA axis recovery post-ACTH-secreting tumor surgery

STEP 1 — Gather Information

Collect postoperative clinical status, surgical pathology confirming ACTH-secreting tumor, timing of surgery, assess for symptoms of adrenal insufficiency (fatigue, hypotension, hyponatremia), obtain morning cortisol level and consider ACTH stimulation test if cortisol equivocal.
→ Proceed to evaluate HPA axis function.

STEP 2 — Rule In / Rule Out

Rule in adrenal insufficiency if morning cortisol <5 µg/dL or subnormal peak cortisol <18.1 µg/dL after standard (250 µg) ACTH stimulation; rule out if morning cortisol ≥15 µg/dL and normal ACTH stim peak.
→ Classify HPA axis recovery status.

STEP 3 — Classify or Stratify

Stratify HPA axis recovery as none (AI present), partial (subnormal response), or full (normal cortisol dynamics).
→ Decide on glucocorticoid management.

STEP 4 — Decide

Continue glucocorticoid replacement (hydrocortisone 15–20 mg daily in divided doses) until full HPA axis recovery is confirmed; taper gradually once normal axis function demonstrated.
→ Provide GC replacement plan.

Clinical Guardrails / Mimics / Pitfalls

Do not stop glucocorticoids prematurely based solely on absence of symptoms; avoid over-replacement leading to iatrogenic Cushingoid features, hyperglycemia, or osteoporosis; consider stress dosing for intercurrent illness even if baseline axis appears recovering.

Concrete Clinical Example

A 45-year-old woman with ACTH-secreting pituitary macroadenoma undergoes transsphenoidal resection; postoperative day 1 she receives hydrocortisone 20 mg daily. Morning cortisol on postoperative day 3 is 2 µg/dL. She continues hydrocortisone 15 mg AM/5 mg PM. At 3 months, morning cortisol is 12 µg/dL with subnormal ACTH stim peak (14 µg/dL); she continues GC replacement. At 6 months, morning cortisol 18 µg/dL and ACTH stim peak 22 µg/dL; glucocorticoids are tapered over 4 weeks and discontinued.

Source: Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, doi:10.1210/jc.2016-2118

---name: ata-post-acth-tumor-gcdescription: Recommend continuing glucocorticoid replacement until hypothalamic-pituitary-adrenal (HPA) axis recovery after surgical resection of ACTH-secreting pituitary tumors. Use when managing postoperative patients following ACTH-secreting tumor surgery to prevent adrenal insufficiency during HPA axis recovery.---# Continue glucocorticoid replacement until HPA axis recovery post-ACTH-secreting tumor surgery## STEP 1 — Gather InformationCollect postoperative clinical status, surgical pathology confirming ACTH-secreting tumor, timing of surgery, assess for symptoms of adrenal insufficiency (fatigue, hypotension, hyponatremia), obtain morning cortisol level and consider ACTH stimulation test if cortisol equivocal. → Proceed to evaluate HPA axis function.## STEP 2 — Rule In / Rule OutRule in adrenal insufficiency if morning cortisol <5 µg/dL or subnormal peak cortisol <18.1 µg/dL after standard (250 µg) ACTH stimulation; rule out if morning cortisol ≥15 µg/dL and normal ACTH stim peak. → Classify HPA axis recovery status.## STEP 3 — Classify or StratifyStratify HPA axis recovery as none (AI present), partial (subnormal response), or full (normal cortisol dynamics). → Decide on glucocorticoid management.## STEP 4 — DecideContinue glucocorticoid replacement (hydrocortisone 15–20 mg daily in divided doses) until full HPA axis recovery is confirmed; taper gradually once normal axis function demonstrated. → Provide GC replacement plan.## Clinical Guardrails / Mimics / PitfallsDo not stop glucocorticoids prematurely based solely on absence of symptoms; avoid over-replacement leading to iatrogenic Cushingoid features, hyperglycemia, or osteoporosis; consider stress dosing for intercurrent illness even if baseline axis appears recovering.## Concrete Clinical ExampleA 45-year-old woman with ACTH-secreting pituitary macroadenoma undergoes transsphenoidal resection; postoperative day 1 she receives hydrocortisone 20 mg daily. Morning cortisol on postoperative day 3 is 2 µg/dL. She continues hydrocortisone 15 mg AM/5 mg PM. At 3 months, morning cortisol is 12 µg/dL with subnormal ACTH stim peak (14 µg/dL); she continues GC replacement. At 6 months, morning cortisol 18 µg/dL and ACTH stim peak 22 µg/dL; glucocorticoids are tapered over 4 weeks and discontinued.**Source:** Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, doi:10.1210/jc.2016-2118

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