Editing Procaine (section)

==Adverse effects==
Application of procaine leads to the depression of neuronal activity. The depression causes the nervous system to become hypersensitive, producing restlessness and shaking, leading to minor to severe convulsions.{{citation needed|date=July 2022}} Studies on animals have shown the use of procaine led to the increase of [[dopamine]] and [[serotonin]] levels in the brain.<ref name="pmid2622091">{{cite journal | vauthors = Sawaki K, Kawaguchi M | title = Some correlations between procaine-induced convulsions and monoamines in the spinal cord of rats | journal = Japanese Journal of Pharmacology | volume = 51 | issue = 3 | pages = 369–76 | date = November 1989 | pmid = 2622091 | doi = 10.1254/jjp.51.369 | doi-access = free }}</ref> Other issues may occur because of varying individual tolerance to procaine dosage. Nervousness and dizziness can arise from the excitation of the central nervous system, which may lead to respiratory failure if overdosed. Procaine may also induce weakening of the [[myocardium]], leading to [[cardiac arrest]].<ref>{{cite web | url = https://www.drugs.com/pro/novocain.html | work = drugs.com | title = Novocain Official FDA information | date = August 2007 }}</ref>

Procaine can also cause allergic reactions causing individuals to have problems with breathing, rashes, and swelling. Allergic reactions to procaine are usually not in response to procaine itself, but to its metabolite PABA. Allergic reactions are in fact quite rare, estimated to have an incidence of 1 per 500,000 injections. About one in 3000 white North Americans is homozygous (i.e. has two copies of the abnormal gene) for the most common atypical form of the enzyme pseudocholinesterase,<ref>{{cite book | first = Ludwig | last = Ombregt | name-list-style = vanc | chapter = Procaine: Principles of Treatment | pages = 83–115 | title = A System of Orthopaedic Medicine | edition = 3rd | date = 2013 | doi = 10.1016/B978-0-7020-3145-8.00005-3 | isbn = 978-0-7020-3145-8 | publisher = Churchill Livingstone }}</ref><ref name=OMIM_BCh>{{cite web |title=Butyrylcholinesterase |url=http://www.omim.org/entry/177400 |website=OMIM |access-date=4 September 2015}}</ref> and do not hydrolyze ester anesthetics such as procaine. This results in a prolonged period of high levels of the anesthetic in the blood and increased toxicity.

However, certain populations in the world such as the [[Arya Vysya|Vysya community]] in India commonly have a deficiency of this enzyme.<ref name="OMIM_BCh" />