<prompt> Muscle relaxant of choice in a patient with serum bilirubin of 6 mgdl and serum creatinine of 4.5 mgdl is:VecuroniumAtracuriumPancuroniumMivacurium  <response>: Ans. B AtracuriumRef: KDT 8the p380Atracurium is eliminated by Hoffmans elimination. It means it neither require liver for metabolism, nor kidney for excretion. Its molecules spontaneously rearrange to make it inactive. Thus it is safest muscle relaxant in a patient with liver and kidney disease. 