Muscle Relaxants · NEET PG Preparation Anaesthesia
A 50-year-old man with end-stage renal disease receives vecuronium for general anesthesia. Postoperatively, he experiences prolonged neuromuscular bl…
Practice question from Muscle Relaxants (NEET PG Preparation Anaesthesia), with the correct answer and a step-by-step solution.
medium · MCQ · Q-773F94
A 50-year-old man with end-stage renal disease receives vecuronium for general anesthesia. Postoperatively, he experiences prolonged neuromuscular blockade. Which pharmacokinetic property of vecuronium explains this observation?
- A.Hepatic degradation by plasma esterases
- B.Renal excretion of active metabolitesCorrect answer
- C.Pulmonary elimination
- D.Hofmann elimination
Solution
Vecuronium is dependent on biliary and renal excretion. Its active metabolite, 3-desacetylvecuronium, is eliminated primarily by the kidneys. In renal failure, this metabolite accumulates and can cause prolonged neuromuscular blockade.
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