Atracurium Hofmann Elimination — FRCA Primary MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: A — Its elimination is independent of renal and hepatic function
Option A is correct. Atracurium is inactivated mainly by Hofmann elimination, a spontaneous non-enzymatic chemical degradation, and also by ester hydrolysis catalysed by non-specific esterases. Its elimination is therefore independent of renal and hepatic function. Hofmann elimination is not physiologically invariant: its rate increases with higher pH and temperature and falls with lower pH or temperature, so D is false. Atracurium is intermediate-acting and does not last longer than pancuronium, excluding A. Laudanosine has no neuromuscular blocking activity, but it is not pharmacologically inert; high concentrations have produced hypotension and cerebral excitation in animals, excluding B. Plasma cholinesterase is not responsible for atracurium metabolism, excluding E.
Reference: Hospira UK Ltd. Atracurium Besilate 10 mg/ml Solution for Injection/Infusion, Summary of Product Characteristics, sections 4.4 and 5.2, updated 2025. https://www.medicines.org.uk/emc/product/3785/smpc