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Local Anesthetics, Systemic Effects. Toxicity of LAs is mostly related to their inhibitory effects on excitable cells such as neurons, cardiac muscle, smooth muscle and skeletal muscle cells:. CNSFollowing absorption, LAs cause stimulation of the CNS, producing restlessness and tremors that may progress to convulsion. Central stimulation is followed by depression; death usually is caused by respiratory failure Drowsiness is the most frequent complaint that results from the CNS actions of LAsC21
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