The Life-Cycle of Pharmaceuticals in the Environment

DedicationForewordAcknowledgements1: Introduction Abstract1.1 Overview: Do pharmaceuticals pose a significant environmental risk?1.2 Hazardous substances1.3 Pathways to the environment: Life-cycle of pharmaceuticals1.4 Conclusions2: Prescribing practices Abstract2.1 Pharmaceuticals in legislative and healthcare systems2.2 The role of patient medical adherence2.3 Strategies to minimize medication nonadherence2.4 “Doctor, it just doesn’t work!”—Pharmacodynamics, pharmacokinetics, and pharmaceutical waste2.5 “How much are those antibiotics? I want ’em!”2.6 Accumulation of unused medications2.7 Strategies to prevent accumulation of unused pharmaceuticals3: Disposal of unused medications Abstract3.1 Overview3.2 The origins of unused medication3.3 Medication disposal by households3.4 Attitudes toward medication disposal3.5 Feasibility of take-back programmes for unused medication3.6 Management of pharmaceutical waste at take-back depots3.7 The “best” method for the disposal of unused medications?3.8 Conclusions4: Detection and presence of pharmaceuticals in the environment Abstract4.1 Overview4.2 Environmental detection of pharmaceuticals4.3 Sample collection4.4 Sample extraction4.5 Chromatographic separation of environmental sample extracts4.6 Mass spectrometric detection and quantitation4.7 Environmental concentrations of some common pharmaceuticals4.8 Summary5: Impact of pharmaceuticals on the environment Abstract5.1 Overview5.2 Environmental risk assessment methodologies5.3 Experimental variables involved in risk assessment5.4 Ecotoxicology5.5 Mixture toxicity5.6 Case study: Paracetamol (acetaminophen) in the environment5.7 Case study: Fluoxetine in the environment5.8 Case study: Diclofenac in the environment5.9 Summary6: Degradation of pharmaceuticals in wastewater Abstract6.1 Basic steps in wastewater treatment6.2 Removal and degradation of selected human pharmaceuticals6.3 Effect of the natural organic matrix on pharmaceutical removal and degradation in wastewater6.4 Summary and conclusions7: Regulatory practices to control the discharge of pharmaceuticals into the environment Abstract7.1 Overview7.2 The United States of America and Canada7.3 European Union (EU)7.4 China and other parts of Asia7.5 Australia7.6 New Zealand7.7 Challenges and conclusions8: Green chemistry, green pharmacy, and life-cycle assessments Abstract8.1 Green chemistry and green pharmacy8.2 Life-Cycle Assessment (LCA)8.3 Summary9: Summary and Conclusions Abstract9.1 The potential environmental risk of pharmaceuticals?9.2 Some possible future considerationsIndex