A cholinergic agent may bind to muscarinic and nicotinic receptors. Nicotinic receptors are present in autonomic ganglia (sympathetic), skeletal muscle, adrenal medulla, and central nervous system.
Nicotinic effects on skeletal muscles:
(1) twitching
(2) muscle fasciculations
(3) weakness
(4) muscle cramping
Nicotinic effects following sympathetic stimulation:
(1) pallor
(2) tachycardia
(3) hyperglycemia
(4) elevation in blood pressure
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