This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Neuromuscular Blocker, Subject name: Anaesthesia
Prolonged muscle paralysis in a healthy individual may be caused by: 
Select and explain. 
A. d-Tubocurarine, B. Cisatracurium, C. Pancuronium, D. Succinylcholine
D: Succinylcholine
Answer: D: Succinylcholine 
Explanation: Pseudocholinesterase deficiency is an inherited enzyme abnormality that results in abnormally slow metabolic degradation of exogenous choline ester drugs such as succinylcholine and mivacurium. If there is a deficiency in the plasma activity of pseudocholinesterase, prolonged muscular paralysis may occur, resulting in the extended need for mechanical ventilation. A variety of pathologic conditions, physiologic alterations, and medications also can lower plasma pseudocholinesterase activity. Succinylcholine apnea may be seen suddenly in healthy individual due to deficiency of pseudocholinesterase .