All of the following are true about depolarizing agents, EXCEPT:
High-Yield Explanation
Pancuronium consists of a steroid ring on which two modified ACh molecules are positioned. It resembles ACh enough to bind (but not activate) the nicotinic ACh receptor. Rocuronium undergoes no metabolism and is eliminated primarily by the liver and slightly by the kidneys. Because of its unique metabolism, atracurium's duration of action can be markedly prolonged by hypothermia and to a lesser extent by acidosis. Vecuronium is metabolized to a small extent by the liver. It depends primarily on biliary excretion and secondarily (25%) on renal excretion. Although it is a satisfactory drug for patients with renal failure, its duration of action is somewhat prolonged. Ref: Butterwoh IV J.F., Mackey D.C., Wasnick J.D. (2013). Chapter 11. Neuromuscular Blocking Agents. In J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e.