11. They get pain relief without any systemic effects that might cause them to be disqualified. 12. Around 49 % of brown recluse bites do not result in necrosis or systemic effects . 13. These systemic effects are caused by a traumatic rhabdomyolysis. 14. It is applied topically or ingested for systemic effects . 15. Rarely, the venom is carried by the blood stream into internal organs causing systemic effects . 16. Leptin and ghrelin are both hormones that have powerful systemic effects on eating and metabolism. 17. The main metabolite of alcaftadine is a carboxylic acid metabolite that has minimal systemic effects . 18. The toxin causes several systemic effects , among which is an increased release of insulin, causing hypoglycemia. 19. Catecholamines have many systemic effects on multiple organs. 20. They have autocrine, paracrine and / or endocrine effects; their systemic effects occur at picomolar concentrations.