How do I install the Enda Avoid Long Acting Glucocorticoids Children skill?

Run npx skillmds@latest add dromlakhani/enda-avoid-long-acting-glucocorticoids-children 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 Enda Avoid Long Acting Glucocorticoids Children safe to use?

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Which AI agents work with Enda Avoid Long Acting Glucocorticoids Children?

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 Enda Avoid Long Acting Glucocorticoids Children free to use?

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Who published Enda Avoid Long Acting Glucocorticoids Children?

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

Enda Avoid Long Acting Glucocorticoids Children by dromlakhani

Name: Enda Avoid Long Acting Glucocorticoids Children
Rating: 4.5 (4 reviews)
Author: dromlakhani

Enda Avoid Long Acting Glucocorticoids Children

Suggests avoiding synthetic, long-acting glucocorticoids (e.g., prednisolone, dexamethasone) in children with primary adrenal insufficiency (PAI). Use when selecting glucocorticoid replacement for a child with PAI to prevent Cushingoid side effects and dose titration difficulties.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Avoid Synthetic, Long-Acting Glucocorticoids in Children with PAI

STEP 1 — Gather Information

Confirm diagnosis of PAI in the child (via ACTH stimulation test or clinical/lab criteria) and assess need for glucocorticoid replacement therapy.

STEP 2 — Rule In / Rule Out

If the child has PAI and requires glucocorticoid replacement, rule out synthetic, long-acting glucocorticoids (prednisolone, dexamethasone) due to risks in pediatric PAI.

STEP 3 — Classify or Stratify

Classify glucocorticoid options: preferred short-acting agents (hydrocortisone, cortisone acetate) versus avoided long-acting agents (prednisolone, dexamethasone).

STEP 4 — Decide

Initiate glucocorticoid replacement with hydrocortisone (8 mg/m²/day in three or four divided doses) or cortisone acetate (20–35 mg/day in two or three divided doses); avoid prednisolone and dexamethasone entirely.

Clinical Guardrails / Mimics / Pitfalls

Do not use dexamethasone due to high risk of Cushingoid side effects and difficulty in dose titration. Avoid prednisolone in children with PAI as it is long-acting and may cause overexposure; if hydrocortisone is unavailable, prednisolone is a last-resort alternative only with extreme caution (per guideline 3.3), but dexamethasone remains least preferred.

Concrete Clinical Example

A 6-year-old girl with PAI (autoimmune etiology) is started on hydrocortisone 9 mg/m²/day in three divided doses (5 mg/m² morning, 2 mg/m² noon, 2 mg/m² evening) after confirming low cortisol and high ACTH. Prednisolone and dexamethasone are avoided per guideline 3.19.

Source: Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI: 10.1210/jc.2015-1710

---name: enda-avoid-long-acting-glucocorticoids-childrendescription: Suggests avoiding synthetic, long-acting glucocorticoids (e.g., prednisolone, dexamethasone) in children with primary adrenal insufficiency (PAI). Use when selecting glucocorticoid replacement for a child with PAI to prevent Cushingoid side effects and dose titration difficulties.---# Avoid Synthetic, Long-Acting Glucocorticoids in Children with PAI## STEP 1 — Gather InformationConfirm diagnosis of PAI in the child (via ACTH stimulation test or clinical/lab criteria) and assess need for glucocorticoid replacement therapy.## STEP 2 — Rule In / Rule OutIf the child has PAI and requires glucocorticoid replacement, rule out synthetic, long-acting glucocorticoids (prednisolone, dexamethasone) due to risks in pediatric PAI.## STEP 3 — Classify or StratifyClassify glucocorticoid options: preferred short-acting agents (hydrocortisone, cortisone acetate) versus avoided long-acting agents (prednisolone, dexamethasone).## STEP 4 — DecideInitiate glucocorticoid replacement with hydrocortisone (8 mg/m²/day in three or four divided doses) or cortisone acetate (20–35 mg/day in two or three divided doses); avoid prednisolone and dexamethasone entirely.## Clinical Guardrails / Mimics / PitfallsDo not use dexamethasone due to high risk of Cushingoid side effects and difficulty in dose titration. Avoid prednisolone in children with PAI as it is long-acting and may cause overexposure; if hydrocortisone is unavailable, prednisolone is a last-resort alternative only with extreme caution (per guideline 3.3), but dexamethasone remains least preferred.## Concrete Clinical ExampleA 6-year-old girl with PAI (autoimmune etiology) is started on hydrocortisone 9 mg/m²/day in three divided doses (5 mg/m² morning, 2 mg/m² noon, 2 mg/m² evening) after confirming low cortisol and high ACTH. Prednisolone and dexamethasone are avoided per guideline 3.19.**Source:** Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI: 10.1210/jc.2015-1710

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