How do I install the Es Gh Treatment Regimen skill?

Run npx skillmds@latest add dromlakhani/es-gh-treatment-regimen 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 Es Gh Treatment Regimen safe to use?

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Which AI agents work with Es Gh Treatment Regimen?

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 Es Gh Treatment Regimen free to use?

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

Who published Es Gh Treatment Regimen?

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

Es Gh Treatment Regimen by dromlakhani

Name: Es Gh Treatment Regimen
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es Gh Treatment Regimen

This skill selects the appropriate growth hormone treatment regimen for childhood cancer survivors with confirmed growth hormone deficiency. It advises using the same dosing and monitoring strategies as for individuals with GHD from the noncancer population, triggered by questions such as “What GH dose and schedule should I use for this survivor?” or “How do I determine growth hormone therapy parameters in childhood cancer?”

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Select growth hormone regimen for childhood cancer survivors

STEP 1 — Gather Information

Confirm diagnosis of growth hormone deficiency via provocative testing (e.g., insulin tolerance test, glucagon) per guideline 2.3; verify at least 1 year disease‑free after completion of anticancer therapy; obtain baseline height, weight, pubertal status, and IGF‑I level; assess for contraindications (active malignancy, untreated central hypothyroidism or adrenal insufficiency, uncontrolled seizures).

STEP 2 — Rule In / Rule Out

Rule out active malignancy or disease‑free interval <1 year; rule out untreated severe hypothyroidism or adrenal insufficiency that must be corrected before GH initiation; rule out known hypersensitivity to somatropin.

STEP 3 — Classify or Stratify

Classify patient as eligible for GH therapy if GHD confirmed and disease‑free ≥1 year; note that dosing follows weight‑based regimens used in noncancer GHD (e.g., 0.024–0.03 mg/kg/day subcutaneously at night) and that spinal radiation may limit spinal height gain.

STEP 4 — Decide

Initiate GH therapy using standard noncancer regimens; monitor IGF‑I every 3–6 months and adjust dose to keep IGF‑I SDS within –2 to +2 for age, sex, and pubertal status; assess growth velocity every 6 months; evaluate for slipped capital femoral epiphysis, scoliosis progression, and intracranial hypertension periodically.

Clinical Guardrails / Mimics / Pitfalls

Do not start GH in patients with active malignancy or <1 year disease‑free; avoid exceeding IGF‑I SDS >+2 to reduce risk of adverse metabolic effects; monitor for slipped capital femoral epiphysis (especially in obese or rapidly growing adolescents) and worsening scoliosis; recognize that GH may improve limb length but not spinal height in those with spinal irradiation; ensure concomitant hormone deficiencies (TSH, ACTH, gonadotropins) are replaced.

Concrete Clinical Example

A 12‑year‑old male survivor of medulloblastoma received 24 Gy cranial radiation, completed therapy 2 years ago, has confirmed GHD (peak GH <5 µg/L on insulin tolerance test), IGF‑I SDS –2.5, no active disease. Start GH 0.03 mg/kg/day subcutaneously at night; after 4 months IGF‑I SDS –0.8, increase to 0.035 mg/kg/day; after 6 months growth velocity 6 cm/year; monitor IGF‑I every 4 months and watch for hip pain.

Source: Hypothalamic Pituitary and Growth Disorders in Survivors of Childhood Cancer, Sklar et al., Endocrine Society Clinical Practice Guideline, 2018, doi:10.1210/jc.2018-01175

---name: es-gh-treatment-regimendescription: This skill selects the appropriate growth hormone treatment regimen for childhood cancer survivors with confirmed growth hormone deficiency. It advises using the same dosing and monitoring strategies as for individuals with GHD from the noncancer population, triggered by questions such as “What GH dose and schedule should I use for this survivor?” or “How do I determine growth hormone therapy parameters in childhood cancer?”---# Select growth hormone regimen for childhood cancer survivors## STEP 1 — Gather InformationConfirm diagnosis of growth hormone deficiency via provocative testing (e.g., insulin tolerance test, glucagon) per guideline 2.3; verify at least 1 year disease‑free after completion of anticancer therapy; obtain baseline height, weight, pubertal status, and IGF‑I level; assess for contraindications (active malignancy, untreated central hypothyroidism or adrenal insufficiency, uncontrolled seizures).## STEP 2 — Rule In / Rule OutRule out active malignancy or disease‑free interval <1 year; rule out untreated severe hypothyroidism or adrenal insufficiency that must be corrected before GH initiation; rule out known hypersensitivity to somatropin.## STEP 3 — Classify or StratifyClassify patient as eligible for GH therapy if GHD confirmed and disease‑free ≥1 year; note that dosing follows weight‑based regimens used in noncancer GHD (e.g., 0.024–0.03 mg/kg/day subcutaneously at night) and that spinal radiation may limit spinal height gain.## STEP 4 — DecideInitiate GH therapy using standard noncancer regimens; monitor IGF‑I every 3–6 months and adjust dose to keep IGF‑I SDS within –2 to +2 for age, sex, and pubertal status; assess growth velocity every 6 months; evaluate for slipped capital femoral epiphysis, scoliosis progression, and intracranial hypertension periodically.## Clinical Guardrails / Mimics / PitfallsDo not start GH in patients with active malignancy or <1 year disease‑free; avoid exceeding IGF‑I SDS >+2 to reduce risk of adverse metabolic effects; monitor for slipped capital femoral epiphysis (especially in obese or rapidly growing adolescents) and worsening scoliosis; recognize that GH may improve limb length but not spinal height in those with spinal irradiation; ensure concomitant hormone deficiencies (TSH, ACTH, gonadotropins) are replaced.## Concrete Clinical ExampleA 12‑year‑old male survivor of medulloblastoma received 24 Gy cranial radiation, completed therapy 2 years ago, has confirmed GHD (peak GH <5 µg/L on insulin tolerance test), IGF‑I SDS –2.5, no active disease. Start GH 0.03 mg/kg/day subcutaneously at night; after 4 months IGF‑I SDS –0.8, increase to 0.035 mg/kg/day; after 6 months growth velocity 6 cm/year; monitor IGF‑I every 4 months and watch for hip pain.**Source:** Hypothalamic Pituitary and Growth Disorders in Survivors of Childhood Cancer, Sklar et al., Endocrine Society Clinical Practice Guideline, 2018, doi:10.1210/jc.2018-01175

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