Which is the muscle relaxant of choice in renal failure?
High-Yield Explanation
Atracurium and cis-atracurium are inactivated by Hoffman's elimination. It is the spontaneous molecular re- arrangement of these drugs leading to their inactivation without the requirement of liver or kidney. Therefore they are the muscle relaxants of choice for renal and hepatic failure patients. Also know Elimination of muscle relaxants: Renal Hepatic Both None Doxacurium Rapacuronium Pipecuronium Atracurium Tubocurarine Vecuronium Cis-atracurium Pancuronium Rocuronium Mivacurium Succinyl choline Ref: Katzung 9th/pg. 432; KDT 6th/pg. 345.