All of the following are true about atracurium, EXCEPT:
Correct Answer: Histamine release is rare
Description: Atracurium triggers dose-dependent histamine release that becomes significant at doses above 0.5 mg/kg. Ester hydrolysis (catalyzed by nonspecific esterases) and Hofmann elimination (spontaneous nonenzymatic chemical breakdown) are responsible for metabolism. Laudanosine, a teiary amine, is a breakdown product of atracurium's Hofmann elimination and has been associated with central nervous system excitation, resulting in elevation of the minimum alveolar concentration and even precipitation of seizures. Atracurium should be avoided in asthmatic patients because of severe bronchospasm. 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.
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