<prompt> Muscle relaxant of choice in a patient with serum bilirubin 6mgdl and serum creatinine of 4.5mgdlVecuroniumAtracuriumPancuroniumMivacurium  <response>: Refer KDT 7th, 353 Atracurium is eliminated by Hoffmans elimination. It means it neither require liver for metabolism nor kidney for excretion. Its molecules spontaneously reaarnge to make it reactivity. Thus it safest muscle relaxed in a patient on a patient with liver and kidney disease 