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What is Advantage of cisatracurium over atracurium is? and explain in detail?
Ans. (D) Releases less histamine(Ref: Goodman and Gilman 13th/e p182)Both atracurium and cis-atracurium are non-depolarizing neuromuscular blockers.Both of these are intermediate acting agents (both have same duration of action).Both of these agents are cardiostableAtracurium has faster onset of action as compared to cis-atracurium.Both are eliminated by Hoffman's elimination. Atracurium is also metabolized by liver to some extent and result in production of a metabolite laudanosine that can cause CNS toxicity including seizures. On the other hand cis-atracurium is almost completely eliminated by Hoffman's elimination and produce negligible laudanosine.Major advantage of cis-atracurium over atracurium is that the former do not release histamine.