This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Muscle relaxants, Subject name: Anaesthesia
Which of the following can be given in hepatic as well as in renal failure 
Select and explain. 
A. Atracurium, B. Vecuronium, C. Pancuronium, D. Mivacurium
A: Atracurium
Answer: A: Atracurium 
Explanation: Atracurium and Cis-atracurium are the muscle relaxants of choice in both liver and renal failure. Atracurium is inactivated by Hoffman's elimination and alkaline ester hydrolysis. Cis-atracurium is eliminated by Hoffman's elimination. Hence atracurium and cis-Atracurium duration of action is not altered in patients with hepatic or renal insufficiency or hemodynamic compromise .Therefore, preferred muscle relaxants for such patients as well as for neonates and elderly.