Patient undergoing surgical operation under anesthesia, may be has a concomitant diseases .the chronic administration of this drug may be interact with anesthetics by many route.it may be affect patients systems which is in turn may lead to modification of anesthetic technique, or interact with anesthetic drugs leads to avoid certain anesthetics, or reduction of the dose needed. The anesthesia must be aware with these drugs, about their side effects, full preoperative history is needed, proper evaluation of the systems affected, for example chemotherapy drugs have a cardiac toxicity, pulmonary toxicity, hepatorenal, and coagulation abnormalities .immuno supressents for auto immune diseases, mythenia gravis, and others can affect plan of anesthesia . This book focused on some of common diseases facing anesthetist and be a challenge to produce safe anesthesia
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