How do I install the Endo Statin Therapy Persistent Cushing Syndrome skill?

Run npx skillmds@latest add dromlakhani/endo-statin-therapy-persistent-cushing-syndrome 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 Endo Statin Therapy Persistent Cushing Syndrome safe to use?

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Which AI agents work with Endo Statin Therapy Persistent Cushing Syndrome?

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 Endo Statin Therapy Persistent Cushing Syndrome free to use?

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Who published Endo Statin Therapy Persistent Cushing Syndrome?

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

Endo Statin Therapy Persistent Cushing Syndrome by dromlakhani

Name: Endo Statin Therapy Persistent Cushing Syndrome
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo Statin Therapy Persistent Cushing Syndrome

This skill suggests statin therapy as adjunct to lifestyle modification to reduce cardiovascular risk in adults with persistent endogenous Cushing syndrome, irrespective of cardiovascular risk score. Trigger phrases include "Patient with persistent Cushing syndrome", "Assessing statin need in cortisol excess", and "Cardiovascular risk reduction in Cushing syndrome".

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Statin therapy for persistent endogenous Cushing syndrome

STEP 1 — Gather Information

Obtain lipid panel (LDL-C, HDL-C, triglycerides), confirm persistent endogenous Cushing syndrome via biochemical testing after definitive therapy, assess life expectancy and comorbidities, and review current medications (especially mitotane).

STEP 2 — Rule In / Rule Out

Is the patient an adult with biochemically confirmed persistent endogenous Cushing syndrome? If yes, proceed to STEP 3; if no, consider alternative diagnoses or cured Cushing syndrome and follow general population lipid management.

STEP 3 — Classify or Stratify

Measure LDL-C: if LDL-C >70 mg/dL (1.8 mmol/L), classify as candidate for statin initiation; if LDL-C ≤70 mg/dL, still consider statin based on overall cardiovascular risk but plan reassessment in 3–6 months.

STEP 4 — Decide

Initiate moderate-intensity statin (e.g., atorvastatin 10–20 mg daily or rosuvastatin 5–10 mg daily) as adjunct to lifestyle modification (dietary changes, increased physical activity); obtain baseline liver enzymes and creatine kinase; schedule follow‑up lipid panel and safety labs in 3–6 months.

Clinical Guardrails / Mimics / Pitfalls

Do not initiate statin therapy in pregnancy or in patients attempting pregnancy; avoid simvastatin and lovastatin when patients are on mitotane due to increased risk of myotoxicity—prefer fluvastatin, pravastatin, or rosuvastatin; statin therapy may be inappropriate in patients with limited life expectancy (e.g., untreated malignancy); monitor for statin‑associated muscle symptoms and hepatic enzyme elevations.

Concrete Clinical Example

A 48‑year‑old woman with persistent Cushing syndrome after transsphenoidal adenomectomy has LDL‑C 138 mg/dL, HDL‑C 42 mg/dL, triglycerides 160 mg/dL, and is not pregnant. She is started on atorvastatin 20 mg daily plus Mediterranean diet and brisk walking 30 minutes daily; lipids are rechecked at 4 months showing LDL‑C 78 mg/dL with no adverse effects.

Source: Lipid Management in Patients with Endocrine Disorders: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2020, doi:10.1210/clinem/dgaa674

---name: endo-statin-therapy-persistent-cushing-syndromedescription: This skill suggests statin therapy as adjunct to lifestyle modification to reduce cardiovascular risk in adults with persistent endogenous Cushing syndrome, irrespective of cardiovascular risk score. Trigger phrases include "Patient with persistent Cushing syndrome", "Assessing statin need in cortisol excess", and "Cardiovascular risk reduction in Cushing syndrome".---# Statin therapy for persistent endogenous Cushing syndrome## STEP 1 — Gather InformationObtain lipid panel (LDL-C, HDL-C, triglycerides), confirm persistent endogenous Cushing syndrome via biochemical testing after definitive therapy, assess life expectancy and comorbidities, and review current medications (especially mitotane).## STEP 2 — Rule In / Rule OutIs the patient an adult with biochemically confirmed persistent endogenous Cushing syndrome? If yes, proceed to STEP 3; if no, consider alternative diagnoses or cured Cushing syndrome and follow general population lipid management.## STEP 3 — Classify or StratifyMeasure LDL-C: if LDL-C >70 mg/dL (1.8 mmol/L), classify as candidate for statin initiation; if LDL-C ≤70 mg/dL, still consider statin based on overall cardiovascular risk but plan reassessment in 3–6 months.## STEP 4 — DecideInitiate moderate-intensity statin (e.g., atorvastatin 10–20 mg daily or rosuvastatin 5–10 mg daily) as adjunct to lifestyle modification (dietary changes, increased physical activity); obtain baseline liver enzymes and creatine kinase; schedule follow‑up lipid panel and safety labs in 3–6 months.## Clinical Guardrails / Mimics / PitfallsDo not initiate statin therapy in pregnancy or in patients attempting pregnancy; avoid simvastatin and lovastatin when patients are on mitotane due to increased risk of myotoxicity—prefer fluvastatin, pravastatin, or rosuvastatin; statin therapy may be inappropriate in patients with limited life expectancy (e.g., untreated malignancy); monitor for statin‑associated muscle symptoms and hepatic enzyme elevations.## Concrete Clinical ExampleA 48‑year‑old woman with persistent Cushing syndrome after transsphenoidal adenomectomy has LDL‑C 138 mg/dL, HDL‑C 42 mg/dL, triglycerides 160 mg/dL, and is not pregnant. She is started on atorvastatin 20 mg daily plus Mediterranean diet and brisk walking 30 minutes daily; lipids are rechecked at 4 months showing LDL‑C 78 mg/dL with no adverse effects.**Source:** Lipid Management in Patients with Endocrine Disorders: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2020, doi:10.1210/clinem/dgaa674

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