Atracurium elimination — FRCA Primary MCQ

Correct answer: C — It undergoes Hofmann elimination

Atracurium has organ-independent elimination through Hofmann degradation and ester hydrolysis. It directly inhibits activated factor X is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It is hydrolysed by nonspecific esterases is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It blocks voltage-gated sodium channels is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It blocks dopamine D2 receptors is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks