Question

Which chemical structure class of non-depolarizing NMBA undergoes renal elimination to a greater extent?

A) Steroidal
B) Aminosteroidal
C) Benzylisoquinolinium
D) Carbamate

Answer 1

The aminosteroidal class of non-depolarizing neuromuscular blocking agents undergoes renal elimination to a greater extent compared to other types.

Step-by-step explanation:

In the context of non-depolarizing neuromuscular blocking agents (NMBAs), the chemical structure class that undergoes renal elimination to a greater extent is the aminosteroidal class. Non-depolarizing NMBAs are typically used in anesthesia to achieve muscle relaxation during surgeries and other medical procedures. Unlike depolarizing agents, such as succinylcholine, non-depolarizing NMBAs prevent nerve transmission to muscles by competitively blocking the neurotransmitter acetylcholine at the neuromuscular junction, leading to muscle relaxation.

Aminosteroidal NMBAs, such as vecuronium and rocuronium, have a steroidal structure modified with amino groups, which affects their elimination pathways. These agents are predominantly eliminated by the kidneys, whereas other non-depolarizing NMBAs, like those in the benzylisoquinolinium class, undergo more extensive hepatic metabolism and biliary excretion.