Pharma-Ecology

The revised edition of the guide to environmental impact of pharmaceuticals and personal care products

The revised and updated second edition ofPharma-Ecology joins the health and environmental sciences professions' concern over the occurrence and fate of pharmaceutical and personal care products (PPCPs) in the environment and explores how to best minimize their impact. The text highlights the biological effects of various classes of pharmaceutical compounds under clinical settings, their modes of action, and approximate quantities consumed. The second edition contains the most recent knowledge about the ecological impact of PPCPs as more sensitive detection techniques have become available, since the book was first published.

The second edition offers the most up-to-date information on pharma ecology and bridges the gap between medicine, public health, and environmental science. This new edition contains helpful learning objectives for each chapter, as well as a brief section at the end of each chapter that presents a set of open ended questions. This vital resource:

    Explores the biological effects of pharmaceutical compounds under clinical settings, their modes of action, approximate quantities consumed

    Provides researchers and scientists with critical background data on the environmental impacts of PPCPs

    Contains the most current information on PPCPs' ecological impacts, based on new detection techniques

    Bridges the gap between medicine, public health, and environmental science

Written for ecologists, engineers, microbiologists, pharmacists, toxicologists, chemists, physicians, and veterinarians involved in pollution and environmental analysis, the second edition ofPharma-Ecologycontains the most current information available on the environmental impact of pharmaceuticals and personal care products.

Patrick K. Jjemba, PhD, MBA, is the Director of Operations at DE&P Technical Services, an environmental consultancy company engaged in water and wastewater treatment, quality control, operations, and process improvement.

Preface ix

1 Usage of Pharmaceutical and Personal Care Products1

1.1 Pharmaceutical Consumption Trends 9

Study Questions 11

References 12

2 Most Prescribed Pharmaceuticals and Related Endpoints15

2.1 Antihypertensive and Cardiovascular 16

2.2 Anxiolytic Sedatives, Hypnotics, and Antipsychotics 21

2.3 Analgesics and Antiinflammatory Drugs 29

Study Questions 33

References 33

3 Usage of Antimicrobial Agents and Related Endpoints39

3.1 Cell Wall Synthesis Inhibiting Antibiotics 41

3.2 Inhibitors of Protein Synthesis 46

3.3 Nucleic Acid Synthesis Inhibitors 60

3.4 Antagonism to Metabolic Processes 67

3.5 Antibiotics that Disrupt Membrane Integrity 68

3.6 Other Antimicrobials 69

Study Questions 70

References 70

4 Usage of Other Groups of Pharmaceuticals and Related Endpoints75

4.1 Gastrointestinal Drugs 76

4.2 Antidiabetic Drugs 78

4.3 Diuretics and Electrolytes 79

4.4 Thyroid System Medication 81

4.5 Respiratory Drugs 82

4.6 Oral Contraceptive and Reproductive Therapeutics 84

4.7 Biophosphonates and Other Skeletal Ailment Drugs 90

4.8 Steroids 91

4.9 Hematologic Drugs 94

4.10 Nutritional Drugs 94

4.11 Triptans 95

4.12 Anesthetics 96

4.13 Antineoplastics and Immunosuppressants 97

Study Questions 98

References 98

5 Personal Care Products of Environmental Concern103

5.1 Fragrances and Musks 104

5.2 Ultraviolet Light Filters 111

5.3 Detergents 111

5.4 Disinfectants 114

Study Questions 115

References 116

6 Detection and Occurrence of PPCPs in the Environment119

6.1 Detection of PPCPs in the Environment 123

6.1.1 Detection Using Instrumentation 126

6.1.2 Detection Using Bioassays 127

6.2 Occurrence of PPCPs in Various Environments 131

6.2.1 Aquatic Systems 133

6.2.1.1 PPCPs in Wastewater 133

6.2.1.2 PPCPs in Surface Water 141

6.2.1.3 PPCPs in Groundwater 146

6.2.1.4 PPCPs in Potable Water 149

6.2.2 Occurrence of PPCPs in Sediments 152

6.2.3 Occurrence of PPCPs in Soil 152

6.2.4 PPCPs in Aerial Environments 154

6.3 Excretion as a Driver of Pharmaceutical Occurrence in the Environment 158

Study Questions 162

References 163

7 Ecopharmacokinetics and Ecopharmacodynamics of PPCPs177

7.1 Overview of Pharmacokinetics and Pharmacodynamics 178

7.1.1 PPCP Sorption and Bioavailability in the Environment 188

7.1.2 Compound Halflife and Clearance 192

7.2 Degradation of PPCPs in the Environment 196

7.2.1 Degradation of Antibiotics in the Environment 197

7.2.1.1 Degradation of Quinolone Compounds 198

7.2.1.2 Fate of Lactams and Cephalosporins 199

7.2.1.3 Degradation of Tetracyclines 201

7.2.1.4 Degradation of Macrolides 203

7.2.1.5 Fate of Other Important Groups of Antibiotics 203

7.2.2 Degradation of Analgesics and Antiinflammatory Drugs 204

7.2.3 Degradation of Estrogens and Other Reproductive Hormones 207

7.2.4 Degradation of Other Important Pharmaceuticals 210

7.2.5 Degradation of Surfactants 210

7.3 Role of Physicochemical Factors in the Fate of PPCPs in the Environment 211

7.3.1 Molecular Size as an Attribute to Absorption and Persistence 211

7.3.2 Solubility and Hydrolysis 212

7.3.3 Effects of Dissociation, Partitioning, and Lipophilicity on Degradability 214

7.3.4 Effects of Moisture and Oxygen to the Fate of PPCPs in the Environment 217

7.3.5 Effects of Temperature in PPCP Dynamics and Degradation in the Environment 218

7.3.6 Other Determinants of PPCP Fate and Persistence in the Environment 219

7.3.6.1 Presence of Other Compounds 219

7.3.6.2 Photolysis of PPCPs 221

Study Questions 225

References 226

8 Ecotoxicity of Pharmaceuticals and Personal Care Products239

8.1 Conventional Assessment of the Risk 245

8.2 Ecological Impact of PPCPs on Microorganisms and Microbial Processes 250

8.2.1 Antibiotic Resistance 250

8.2.1.1 Acquisition of Antibiotic Resistance 256

8.2.1.2 Mechanisms of Antibiotic Resistance 256

8.2.2 Biogeochemical Perturbations 257

8.3 Effects of PPCPs on Invertebrates 259

8.4 PPCP Ecotoxicity on Aquatic Organisms 261

8.4.1 Endocrine Disrupters in the Aquatic System 264

8.4.2 Effects of Antibiotic Resistance to Aquatic Organisms 269

8.4.3 Ecotoxicological Effects of Cosmetics on Aquatic Organisms 269

8.4.4 Ecotoxicity of Other PPCPs in Aquatic Organisms 270

8.5 Ecotoxicity of PPCPs on Terrestrial Wildlife 272

8.6 Livestock and Human Health 276

8.6.1 Clinical Antibioticresistance Cases 277

8.6.2 PPCPrelated Allergic Reactions 282

8.6.3 Endocrine Disruption in Humans and Livestock 283

8.6.4 Is There an Association Between PPCPs in the Environment and Some Cancers? 284

8.6.5 Other PPCPs of Concern to Humans and Livestock in the Environment 286

8.7 Ecotoxicity of PPCPs on Vegetation 286

8.8 General Considerations in Longterm PPCP Toxicity 287

Study Questions 289

References 290

9 Technologies for Removing and Reducing PPCPs in the Environment313

9.1 Conventional Treatment Systems 316

9.1.1 Primary Treatment 316

9.1.2 Secondary Treatment 317

9.1.2.1 Lagoons 317

9.1.2.2 Fixed Filter Systems 318

9.1.2.3 Suspended Filter Systems 319

9.2 Advanced Treatment Processes 320

9.2.1 Advanced Filtration Systems 321

9.2.1.1 Activated Carbon 321

9.2.1.2 Filtration Membranes 328

9.2.2 Oxidation Processes 338

9.2.2.1 Chlorination 338

9.2.2.2 Ozonation 340

9.2.3 UV Treatment 342

9.2.4 Electrolysis 342

9.2.5 Advanced Oxidation Processes 344

9.3 Effect of Wastewater Retention Time on PPCP Removal 346

9.4 Formulation and Regimen Design for Reduced Environmental Impact 347

9.5 Source Separation of Urine and Decentralization Needs 348

9.6 Future Technological Trends 348

Study Questions 349

References 350

10 Guidelines for a Regulatory Framework on PPCPs in the Environment357

10.1 Improving Assessment of the Risks from PPCPs in the Environment 359

10.2 Effect of Mixtures 363

10.3 Effects of Chronic Exposure to Low PPCP Doses 363

10.4 Use of Quantitative StructureActivity Relationships in Ecotoxicology 364

10.5 Toxicogenomic Approaches for Guiding Regulations 365

10.6 Social Responsibility in Legislation and Making Policy 366

10.7 Drug Approval and Advertising 371

10.8 Use of Prescription Records for Mapping PPCPs 372

Study Questions 373

References 374

Index 377