This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Anesthesia, Subject name: Pharmacology
[{'content': 'Reason for preferring cis-Atracurium over Atracurium is \nSelect and explain. \nA. Does not undergo Hoffman elimination, B. Sho and fast action, C. Lesser provocation of histamine release, D. Equal potency like Atracurium', 'role': 'user'}, {'content': 'Answer: C \nExplanation: * Cis-Atracurium is a R enantiomer of Atracurium that does not provoke histamine release. Compared to Atracurium, Cis-Atracurium is: - * 4 times more potent * Slow in onset of action, but similar duration of action * Not hydrolysed by plasma cholinesterase and has limited hepatic metabolism --> less amount of toxic metabolites are formed. (Cis-Atra also undergoes Hoffman elimination) * Does not provoke histamine release, lesser side effects * Cis-Atracurium is preferred skeletal muscle relaxant in elderly patients and for patients with liver/kidney disease. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 188', 'role': 'assistant'}]