Side effects of nondepolarizing muscle relaxants: relationship to their antinicotinic and antimuscarinic actions.

Since acetylcholine (ACh) is the 'master key' to different subtypes of nicotinic and muscarinic receptors, and muscle relaxants (MRs) available in clinical practice are structurally related to it, MRs may exert their unwanted effects through inhibition of these receptors. Since the subunit composition of nicotinic ACh receptors (nAChRs) of pre- and/or postsynaptic location and the binding potency of MRs to these and muscarinic receptors are different, a search for selective muscle nAChR antagonists without or with less side effects seems to be promising and important for clinical practice.