Amphetamines are powerful, sympathomimetic amines that, when used chronically, can profoundly effect a patient's cardiovascular stability during anesthesia and surgery. Amphetamines are the third most widely abused class of drugs in the United States. They also have legitimate medical use for attention deficit disorder with hyperactivity, exogenous obesity, and narcolepsy. We report a case of a patient with a 40-yr history of chronic amphetamine use having undergone two general anesthesias without complication.

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Amphetamine, a racemic mixture of ␤-phenylisopropylamine, is an indirect sympathomimetic drug. Amphetamine is a powerful central nervous system (CNS) stimulant with peripheral ␣ and ␤ actions. The CNS mechanism of amphetamine appears dependent on the local release of biogenic amines such as norepinephrine from storage sites in nerve terminals (6). Such