Yes, neostigmine has direct nicotinic action in skeletal muscle. Neostigmine is a reversible acetylcholinesterase inhibitor that increases the levels of acetylcholine at the neuromuscular junction, leading to increased stimulation of nicotinic receptors in skeletal muscle. This results in increased muscle contractions and improved muscle strength, making neostigmine a useful medication in the treatment of myasthenia gravis and other neuromuscular disorders.
