How do I install the Ata Ppgl Pain Management Precautions skill?

Run npx skillmds@latest add dromlakhani/ata-ppgl-pain-management-precautions 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.

Is Ata Ppgl Pain Management Precautions safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: docs only. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Ata Ppgl Pain Management Precautions?

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 Ppgl Pain Management Precautions free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Ata Ppgl Pain Management Precautions?

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

Ata Ppgl Pain Management Precautions by dromlakhani

Name: Ata Ppgl Pain Management Precautions
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Ata Ppgl Pain Management Precautions

Coordinates multidisciplinary treatment with palliative care unit for pain management while avoiding medications that risk inducing hypertensive crisis (e.g., metoclopramide, certain antidepressants) in PPGL patients. Triggered by reports of pain in PPGL patient, especially with bone involvement.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Apply precautions for pain management in pheochromocytoma and paraganglioma

STEP 1 — Gather Information

Collect pain characteristics (location, severity, quality), assess for bone metastases via imaging or symptoms, review current medications (especially metoclopramide, antidepressants, dexamethasone), and evaluate palliative care needs. → Proceed to medication risk screening.

STEP 2 — Rule In / Rule Out

Is the patient taking any medication known to induce hypertensive crisis (e.g., metoclopramide, tricyclic antidepressants, SNRIs, MAO inhibitors, high-dose dexamethasone)? If yes, discontinue or avoid these agents; if no, proceed to analgesic selection.

STEP 3 — Classify or Stratify

Classify pain severity using WHO analgesic ladder (mild, moderate, severe) and assess for skeletal-related events (spinal cord compression, hypercalcemia, pathological fractures). → Determine analgesic step and need for adjuvant therapy or bone-directed treatment.

STEP 4 — Decide

Initiate multidisciplinary pain management with palliative care unit, select analgesics per WHO ladder avoiding high-risk agents, consider bone-modifying agents (e.g., zoledronic acid) or radiotherapy for bone metastases, and monitor for side effects and blood pressure.

Clinical Guardrails / Mimics / Pitfalls

Do not use metoclopramide for nausea/vomiting due to hypertensive crisis risk; avoid tricyclic antidepressants and SNRIs for neuropathic pain; avoid high-dose dexamethasone; use opioids with prophylactic laxatives to prevent constipation; avoid NSAIDs if renal impairment; ensure blood pressure monitoring during analgesic initiation.

Concrete Clinical Example

A 58-year-old patient with metastatic PPGL to lumbar spine reports worsening back pain (7/10) despite acetaminophen. Current meds include metoclopramide for nausea. Discontinue metoclopramide, start low-dose morphine with laxative, involve palliative care for opioid titration, add zoledronic acid for bone lesions, and coordinate radiotherapy if pain persists.

Source: Japan Endocrine Society Clinical Practice Guideline for the Diagnosis and Management of Pheochromocytoma and Paraganglioma 2025, Japan Endocrine Society, 2025, doi:10.1507/endocrj.EJ25-0165

---name: ata-ppgl-pain-management-precautionsdescription: Coordinates multidisciplinary treatment with palliative care unit for pain management while avoiding medications that risk inducing hypertensive crisis (e.g., metoclopramide, certain antidepressants) in PPGL patients. Triggered by reports of pain in PPGL patient, especially with bone involvement.---# Apply precautions for pain management in pheochromocytoma and paraganglioma## STEP 1 — Gather InformationCollect pain characteristics (location, severity, quality), assess for bone metastases via imaging or symptoms, review current medications (especially metoclopramide, antidepressants, dexamethasone), and evaluate palliative care needs. → Proceed to medication risk screening.## STEP 2 — Rule In / Rule OutIs the patient taking any medication known to induce hypertensive crisis (e.g., metoclopramide, tricyclic antidepressants, SNRIs, MAO inhibitors, high-dose dexamethasone)? If yes, discontinue or avoid these agents; if no, proceed to analgesic selection.## STEP 3 — Classify or StratifyClassify pain severity using WHO analgesic ladder (mild, moderate, severe) and assess for skeletal-related events (spinal cord compression, hypercalcemia, pathological fractures). → Determine analgesic step and need for adjuvant therapy or bone-directed treatment.## STEP 4 — DecideInitiate multidisciplinary pain management with palliative care unit, select analgesics per WHO ladder avoiding high-risk agents, consider bone-modifying agents (e.g., zoledronic acid) or radiotherapy for bone metastases, and monitor for side effects and blood pressure.## Clinical Guardrails / Mimics / PitfallsDo not use metoclopramide for nausea/vomiting due to hypertensive crisis risk; avoid tricyclic antidepressants and SNRIs for neuropathic pain; avoid high-dose dexamethasone; use opioids with prophylactic laxatives to prevent constipation; avoid NSAIDs if renal impairment; ensure blood pressure monitoring during analgesic initiation.## Concrete Clinical ExampleA 58-year-old patient with metastatic PPGL to lumbar spine reports worsening back pain (7/10) despite acetaminophen. Current meds include metoclopramide for nausea. Discontinue metoclopramide, start low-dose morphine with laxative, involve palliative care for opioid titration, add zoledronic acid for bone lesions, and coordinate radiotherapy if pain persists.**Source:** Japan Endocrine Society Clinical Practice Guideline for the Diagnosis and Management of Pheochromocytoma and Paraganglioma 2025, Japan Endocrine Society, 2025, doi:10.1507/endocrj.EJ25-0165

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