Abstract
Muscle relaxants are strong bases because they contain one, two, or three quaternary ammonium groups to which their neuromuscular blocking effect is related. The presence of these quaternary ammonium groups explains the high water solubility of these agents, which are present in ionized form whatever the pH of the biological fluid. This property explains why muscle relaxants are for the most part excreted in urine without undergoing transformation, and it is well-known that renal failure represents the main cause of prolonged effect of muscle relaxants.
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Duvaldestin, P., Lebrault, C., Strumza, P., Roure, P. (1986). Muscle Relaxants and Liver Disease. In: Hossli, G., Frey, P., Kreienbühl, G. (eds) ZAK Zürich. Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine, vol 188. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71269-2_33
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DOI: https://doi.org/10.1007/978-3-642-71269-2_33
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