Application of Natural Coagulants for Pharmaceutical Removal from Water and Wastewater: A Review

Pharmaceutical contamination threatens both humans and the environment, and several technologies have been adapted for the removal of pharmaceuticals. The coagulation-flocculation process demonstrates a feasible solution for pharmaceutical removal. However, the chemical coagulation process has its drawbacks, such as excessive and toxic sludge production and high production cost. To overcome these shortcomings, the feasibility of natural-based coagulants, due to their biodegradability, safety, and availability, has been investigated by several researchers. This review presented the recent advances of using natural coagulants for pharmaceutical compound removal from aqueous solutions. The main mechanisms of natural coagulants for pharmaceutical removal from water and wastewater are charge neutralization and polymer bridges. Natural coagulants extracted from plants are more commonly investigated than those extracted from animals due to their affordability. Natural coagulants are competitive in terms of their performance and environmental sustainability. Developing a reliable extraction method is required, and therefore further investigation is essential to obtain a complete insight regarding the performance and the effect of environmental factors during pharmaceutical removal by natural coagulants. Finally, the indirect application of natural coagulants is an essential step for implementing green water and wastewater treatment technologies.

Removal of Meropenem by using Lemna minor

In this paper we presented a case study about the removal of a pharmaceutical contamination (in this case Meropenem) from the environment using organic natural substance (in this case study is Lemna minor). The study proved the efficiency of the used material to remove the contamination of three specific contamination levels of Meropenem. The experimental testing proved the concept, the effect on two vital measures (the chemical oxygen demand – COD, and the root length), which showed improvement in both measures. The degradation mechanism was proven to be not arbitrary by testing the degradation behavior measured practically to four kinetic models. The practical work was found to fit perfectly with the Grau second order model as the simulation work included in the paper shows. Based on this study it can be proven that the dangerous chemicals resulted from the residue of a pharmaceutical substances can be removed efficiently using a totally natural environmental friendly material.

Impacts of Psychopharmaceuticals on the Neurodevelopment of Aquatic Wildlife: A Call for Increased Knowledge Exchange across Disciplines to Highlight Implications for Human Health

The global use of psychopharmaceuticals such as antidepressants has been steadily increasing. However, the environmental consequences of increased use are rarely considered by medical professionals. Worldwide monitoring efforts have shown that pharmaceuticals are amongst the multitude of anthropogenic pollutants found in our waterways, where excretion via urine and feces is thought to be the primary mode of pharmaceutical contamination. Despite the lack of clarity surrounding the effects of the unintentional exposure to these chemicals, most notably in babies and in developing fetuses, the US Environmental Protection Agency does not currently regulate any psychopharmaceuticals in drinking water. As the underlying reasons for the increased incidence of mental illness—particularly in young children and adolescents—are poorly understood, the potential effects of unintentional exposure warrant more attention. Thus, although links between environmental contamination and physiological and behavioral changes in wildlife species—most notably in fish—have been used by ecologists and wildlife biologists to drive conservation policy and management practices, we hypothesize that this knowledge may be underutilized by medical professionals. In order to test this hypothesis, we created a hierarchically-organized citation network built around a highly-cited “parent” article to explore connections between aquatic toxicology and medical fields related to neurodevelopment. As suspected, we observed that studies in medical fields such as developmental neuroscience, obstetrics and gynecology, pediatrics, and psychiatry cite very few to no papers in the aquatic sciences. Our results underscore the need for increased transdisciplinary communication and information exchange between the aquatic sciences and medical fields.

Ecopharmacovigilance: Perspectives, concepts, applications, and relationships in modern context

Introduction: Environmental scientists have made great strides to regulate pharmaceutical waste. However, the monitoring of emerging environmental problems induced by drugs should attract the further interest of pharmacy and pharmacovigilance scientists. Ecopharmacovigilance (EPV) as a kind of pharmacovigilance for the atmosphere is widely recognized as essential to minimize the environmental impact of pharmaceutical toxins. Methods: In efforts to answer the environmental issues created by medications, the constructive involvement of the pharmaceutical sector is essential. On a prioritized basis, EPV can target individual pharmaceuticals. For EPV deployment targeting pharmaceutical contamination, certain advice and management practice solutions are recommended. On administration certain drugs are metabolized throughout the bloodstream, being inert or becoming converted to metabolites, whereas others are excreted in the urine or liver and excreted in the sewage. The substances that are released into drainage can be processed into a number of chemicals by a sewage treatment process. Results: The involvement of different drugs and their components have been found in the marine world, with the aquatic environment being the most researched to date. Nanostructure materials have been around for a long time, and their interactions with biological processes have been discussed in various applications to enhance the understanding and importance of environmental and health effects. Conclusions: In order to regulate pharmaceutical residues in effluents, Technologies for sewage water management should be applied. In particular, the presence of pharmacy including pharmacovigilance professionals is also important for enhancing multidisciplinary collaboration.

Adding the Mureş River Basin (Transylvania, Romania) to the List of Hotspots with High Contamination with Pharmaceuticals

Background: The Mureș River Basin is a long-term heavily polluted watershed, in a situation of climate changes with decreasing water flow and related decreasing dilution capacity. Here, a mixture of emerging pollutants such as pharmaceuticals were targeted to reveal potential risks regarding the natural lotic ecosystems. Due to the continuous discharge into the environment, pharmaceuticals are gaining persistent organic pollutant characteristics and are considered emerging pollutants. Based on the hazard quotient, this research highlights the dangerous concentrations of carbamazepine, ibuprofen, furosemide, and enalapril in river water. Results: High levels of four pharmaceutical compounds (carbamazepine, ibuprofen, furosemide, and enalapril) and some of their derived metabolites (enalaprilat, carboxyibuprofen, 1-hydroxyibuprofen, and 2-hydroxyibuprofen) were reported in our study in the Mureș River Basin. Overall, pharmaceutical concentrations were found to be highest in the wastewater treatment plant (WWTP) effluent, median downstream of the WWTP, and lowest upstream of the WWTP, as was expected. For all pharmaceutical compounds tested, we recorded concentrations above the limit of quantification (LOQ) in at least one of the sites tested. Carbamazepine exhibited the highest mean values upstream, downstream, and at the WWTP. As expected, the highest concentrations for all the studied pharmaceutical compounds were detected in the WWTP effluent. All Hazard Quotient (HQ) values were below one (on a logarithmic scale in base 10), with the highest values in the WWTP and the lowest in the river upstream of the WWTP. The HQ intervals were in the same range for furosemide, carbamazepine, and ibuprofen at each of the three different sites: upstream WWTP effluent, and downstream. The interval for enalapril stands out as having the lowest HQ at all three sites. Conclusions: Based on these results, the large and complex hydrographical system Mureș River Basin was transformed from a grey area, with little information about pharmaceutical contamination, to a hotspot in terms of contamination with emerging pollutants. Pharmaceutical compound concentrations were found to be the highest in WWTP effluents. The WWTP effluent concentrations were among the highest in Europe, indicating that treatment plants are the primary source of water pollution with pharmaceuticals compounds. The detected levels were higher than the safety limit for carbamazepine and ibuprofen. The determined HQ values imply that the measured levels do pose a threat to the environment for the studied pharmaceuticals. Based on the obtained results, human communities can assess, monitor, predict, and adapt in time to these already-present regional challenges and risks for sustainable use of natural resources, including water and associated products and services.

Investigation of Events Related to Laboratory-Confirmed Contamination of Pharmaceutical Products: Summary of CDC Consultation

Background: Contaminated pharmaceutical products pose serious infection risks to patients and can lead to significant morbidity and mortality. Contamination at the point of manufacturing or compounding (intrinsic contamination) has the potential to affect large numbers of patients. Public health plays a critical role in detecting and investigating such events. We identified investigations involving intrinsically contaminated pharmaceuticals to characterize the burden and scope of harm associated with these events. Methods: We reviewed Centers for Disease Control and Prevention records to identify US investigations between January 1, 2009, and December 31, 2018, involving laboratory-confirmed contamination of manufactured medications and pharmacy-compounded preparations (P-CPs), using relevant search terms (eg, “medication contamination”). Laboratory confirmation was defined as identification of a pathogen from a manufactured medication or P-CP. We determined the number and type of patient infections associated with these investigations, the number of states involved, pathogens identified, type of medication (sterile or nonsterile), route of administration, and how the contamination event was first identified. We excluded investigations when the mode of production was unknown. Results: We identified 20 investigations in at least 20 states involving laboratory-confirmed contamination of manufactured medications (n = 12) and P-CPs (n = 8). Patient infections were identified in 16 (80%) investigations (9 involving manufactured medications and 7 involving P-CPs) resulting in at least 1,183 infections and at least 73 deaths. Bloodstream infections were the most common infection type (n = 7, 44%). Waterborne pathogens (eg, Serratia marcescens, Burkholderia cepacia) were cultured from medications in 83% (n = 10) of investigations involving manufactured medications and 75% (n = 6) of investigations involving P-CPs. Contamination of sterile pharmaceutical products occurred in 14 (70%) investigations; 11 (79%) of these involved injectables. Information regarding how contaminated pharmaceuticals were first identified was documented for 18 investigations; most cases (n = 14, 78%) started with investigation of patient infections by facilities, public health, or both, which led to laboratory testing of pharmaceuticals and confirmation of contamination. Conclusions: The events summarized here likely underestimate the frequency of intrinsic contamination of pharmaceutical products in the United States. These events can have devastating consequences that impact patients across the country. Waterborne pathogens appear to be the most frequently identified source of contamination in both manufactured medications and P-CPs.Detection, investigation, control, and prevention of pharmaceutical contamination events benefit from collaboration between state and federal public health authorities; without public health intervention. Such contamination may have gone undetected and could have harmed additional patients.Funding: NoneDisclosures: None

Calmodulin inhibition as a mode of action of antifungal imidazole pharmaceuticals in non-target organisms

To improve assessment of risks associated with pharmaceutical contamination of the environment, it is crucial to understand effects and mode of action of drugs in non-target species. The evidence is accumulating that species with well-conserved drug targets are prone to be at risk when exposed to pharmaceuticals. An interesting group of pharmaceuticals released into the environment is imidazoles, antifungal agents with inhibition of ergosterol synthesis as a primary mode of action in fungi. However, imidazoles have also been identified as competitive antagonists of calmodulin (CaM), a calcium-binding protein with phylogenetically conserved structure and function. Therefore, imidazoles would act as CaM inhibitors in various organisms, including those with limited capacity to synthesize sterols, such as arthropods. We hypothesized that effects observed in crustaceans exposed to imidazoles are related to the CaM inhibition and CaM-dependent nitric oxide (NO) synthesis. To test this hypothesis, we measured (i) CaM levels and its gene expression, (ii) NO accumulation and (iii) gene expression of NO synthase (NOS1 and NOS2), in the cladoceran Daphnia magna exposed to miconazole, a model imidazole drug. Whereas significantly increased CaM gene expression and its cellular allocation were observed, supporting the hypothesized mode of action, no changes occurred in either NO synthase expression or NO levels in the exposed animals. These findings suggest that CaM inhibition by miconazole leads to protein overexpression that compensates for the loss in the protein activity, with no measurable downstream effects on NO pathways. The inhibition of CaM in D. magna may have implications for effect assessment of exposure to mixtures of imidazoles in aquatic non-target species.