Which of the following is earliest and shortest acting skeletal muscle relaxant? (* NIMHANS March-2017 Post-MBBS, NIMHANS Pattern Re-exam March 2015; NIMHANS – 2014)
**Core Concept**
Skeletal muscle relaxants are a group of medications used to relieve muscle spasms, stiffness, and pain. They act on the nervous system to prevent or reduce muscle contractions. The question is testing the knowledge of the earliest and shortest-acting skeletal muscle relaxant.
**Why the Correct Answer is Right**
The correct answer is **Succinylcholine**. It is an ultrashort-acting non-depolarizing neuromuscular blocker that acts by competitively inhibiting acetylcholine at the neuromuscular junction. Succinylcholine is broken down by the enzyme **plasma cholinesterase** to succinylmonocholine, which then gets broken down to succinic acid and choline. This rapid breakdown results in its short duration of action.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not specified, so we cannot comment on it.
* **Option B:** This option is also not specified, so we cannot comment on it.
* **Option C:** This option is not specified, so we cannot comment on it.
* **Option D:** This option is also not specified, so we cannot comment on it. However, we can comment on other options in general: Other muscle relaxants like rocuronium, vecuronium, and atracurium have longer durations of action compared to succinylcholine.
**Clinical Pearl / High-Yield Fact**
Remember that succinylcholine has a rapid onset of action, but it can also cause **hyperkalemia** due to the release of potassium ions from the muscle cells. This is a high-yield fact to remember, especially in patients with burns, spinal cord injuries, or other conditions that can lead to muscle damage.
**Correct Answer: C. Succinylcholine**