How do I install the Esa Pa Pediatric Bp Target skill?

Run npx skillmds@latest add dromlakhani/esa-pa-pediatric-bp-target 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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Is Esa Pa Pediatric Bp Target free to use?

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Who published Esa Pa Pediatric Bp Target?

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

Esa Pa Pediatric Bp Target by dromlakhani

Name: Esa Pa Pediatric Bp Target
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Esa Pa Pediatric Bp Target

Establishes age- and gender-specific blood pressure goals for pediatric patients with primary aldosteronism (PA) using published normative data to assess treatment adequacy and avoid over-treatment. Use when managing hypertension in children with PA to evaluate if BP is adequately controlled; triggers include pediatric PA hypertension, BP not normalized with glucocorticoid therapy, and need for age‑specific BP targets.

dromlakhani Updated Aug 19, 2026 10 repo stars

File contents

Determine Blood Pressure Targets for Children with PA

STEP 1 — Gather Information

Collect patient age (years), sex, height (or BMI), weight, current systolic/diastolic BP, glucocorticoid type and dose, confirmation of PA (e.g., GRA genotype or clinical diagnosis), and any comorbidities. → Proceed to STEP 2.

STEP 2 — Rule In / Rule Out

Determine if the patient is a child (<18 years) with confirmed PA requiring glucocorticoid therapy; if not, the skill does not apply (stop). If yes, proceed to STEP 3.

STEP 3 — Classify or Stratify

Using age‑, sex‑, and height‑specific normative BP tables (e.g., NIH childhood BP percentiles), calculate the 90th percentile systolic and diastolic BP as the treatment target; if height unavailable, use age‑sex 90th percentile from population norms. → Proceed to STEP 4.

STEP 4 — Decide

If current BP ≤ target, maintain current glucocorticoid dose; if current BP > target, consider increasing glucocorticoid dose (weight‑adjusted) or adding an MR antagonist, then re‑evaluate BP in 2–4 weeks. → End.

Clinical Guardrails / Mimics / Pitfalls

Avoid excessive glucocorticoid dosing that can cause growth retardation, cushingoid features, or adrenal suppression; do not apply adult BP thresholds (140/90 mmHg) to children; ensure normative data match the child's ethnicity and height; monitor for hypokalemia when adding MR antagonist; do not ignore weight‑based glucocorticoid adjustments.

Concrete Clinical Example

9‑year‑old girl with GRA on prednisone 5 mg daily, BP 128/82 mm Hg, height 130 cm (50th percentile). Age‑sex‑height 90th percentile BP is 115/72 mm Hg; current BP exceeds target, so increase prednisone to 7.5 mg daily and recheck BP in 3 weeks.

Source: The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-4061

TODO: consider adding scripts/calc.py for the esa-pa-pediatric-bp-target calculator

---name: esa-pa-pediatric-bp-targetdescription: Establishes age- and gender-specific blood pressure goals for pediatric patients with primary aldosteronism (PA) using published normative data to assess treatment adequacy and avoid over-treatment. Use when managing hypertension in children with PA to evaluate if BP is adequately controlled; triggers include pediatric PA hypertension, BP not normalized with glucocorticoid therapy, and need for age‑specific BP targets.---# Determine Blood Pressure Targets for Children with PA## STEP 1 — Gather InformationCollect patient age (years), sex, height (or BMI), weight, current systolic/diastolic BP, glucocorticoid type and dose, confirmation of PA (e.g., GRA genotype or clinical diagnosis), and any comorbidities. → Proceed to STEP 2.## STEP 2 — Rule In / Rule OutDetermine if the patient is a child (<18 years) with confirmed PA requiring glucocorticoid therapy; if not, the skill does not apply (stop). If yes, proceed to STEP 3.## STEP 3 — Classify or StratifyUsing age‑, sex‑, and height‑specific normative BP tables (e.g., NIH childhood BP percentiles), calculate the 90th percentile systolic and diastolic BP as the treatment target; if height unavailable, use age‑sex 90th percentile from population norms. → Proceed to STEP 4.## STEP 4 — DecideIf current BP ≤ target, maintain current glucocorticoid dose; if current BP > target, consider increasing glucocorticoid dose (weight‑adjusted) or adding an MR antagonist, then re‑evaluate BP in 2–4 weeks. → End.## Clinical Guardrails / Mimics / PitfallsAvoid excessive glucocorticoid dosing that can cause growth retardation, cushingoid features, or adrenal suppression; do not apply adult BP thresholds (140/90 mmHg) to children; ensure normative data match the child's ethnicity and height; monitor for hypokalemia when adding MR antagonist; do not ignore weight‑based glucocorticoid adjustments.## Concrete Clinical Example9‑year‑old girl with GRA on prednisone 5 mg daily, BP 128/82 mm Hg, height 130 cm (50th percentile). Age‑sex‑height 90th percentile BP is 115/72 mm Hg; current BP exceeds target, so increase prednisone to 7.5 mg daily and recheck BP in 3 weeks.**Source:** The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-4061> **TODO:** consider adding scripts/calc.py for the esa-pa-pediatric-bp-target calculator

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