This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Non-depolarising Neuromuscular Blocking Agents, Subject name: Anaesthesia
Neuromuscular blocker of choice in real failure: 
Select and explain. 
A. Atracurium, B. Pancuronium, C. Rocuronium, D. Tubocurare
A: Atracurium
Answer: A: Atracurium 
Explanation: Ans: A (Atracurium) Ref: Ajay Yadav's Short Textbook of Anaesthesia, 1st ed. Pg 89.Explanation:AtracuriumIt has a unique method of degradationIts metabolism is independent of hepatic and renal functionsIt undergoes HOFFMAN DEGREDATION (95%) and ester hydrolysis (5%) in plasmaSystemic effects,CVS: Can cause hypotension because of histamine releaseResp: Can cause Bronchospasm due to histamine releaseCNS: At higher doses, its metabolic product Laudanosine can precipitate convulsionsAllergic reactions from pruritic rash to angioedema can occurUsesAtracurium is relaxant of choice inHepatic failureRenal failureMyasthenia gravis