Cocaine-positive patients can turn a “routine” anesthetic into a hemodynamic minefield. This course unpacks cocaine’s pharmacology, acute and chronic end-organ effects, and how it alters MAC, pain perception, cardiovascular stability, and airway risk. You’ll learn when to cancel versus proceed, how to manage hypertensive crises without provoking unopposed alpha, when to avoid succinylcholine and ketamine, and how tools like lipid rescue fit into treating toxicity—so you can make confident, evidence-based decisions in these high-stakes cases.