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
Muscle relaxant of choice in a patient with serum bilirubin 6mg/dl and serum creatinine of 4.5mg/dl 
Select and explain. 
A. Vecuronium, B. Atracurium, C. Pancuronium, D. Mivacurium
B: Atracurium
Answer: B: Atracurium 
Explanation: Refer KDT 7th, /353 Atracurium is eliminated by Hoffman's elimination. It means it neither require liver for metabolism nor kidney for excretion. It's molecules spontaneously reaarnge to make it reactivity. Thus it safest muscle relaxed in a patient on a patient with liver and kidney disease