Eco-pharmacovigilance of non-steroidal anti-inflammatory drugs: Necessity and opportunities

He, Bingshu; Wang, Jun; Liu, Juan; Hu, Xingjian

doi:10.1016/j.chemosphere.2017.04.084

Cited by 96 publications

(25 citation statements)

References 90 publications

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“…The presence of a great diversity of commonly used pharmaceuticals, such as antibiotics, anti-inflammatory drugs, antidiabetics, hypotensive drugs, hormones and antidepressants, have been frequently reported to be detected in the environment, including water, sediments, soil, etc., even in the food chain through crop growth and irrigation [3,4,5,6]. Due to their high volume of use, their continuous introduction into the environment, and the lack of effective removal of pharmaceutical residues from the environment, pharmaceuticals have been referred to as pseudo-persistent contaminants [1,7]. As biologically active compounds designed to be effective even at low concentrations, pharmaceuticals that occur in the environment can lead to chronic toxic effects for organisms.…”

Section: Introductionmentioning

confidence: 99%

Attitudes and Practice Regarding Disposal for Unwanted Medications among Young Adults and Elderly People in China from an Ecopharmacovigilance Perspective

et al. 2019

IJERPH

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Due to the expensive cost and uncertain effectiveness of environmental management options in eliminating pharmaceutical residues, recently, decreasing the emission of pharmaceutical pollutants from a drug administration perspective has been considered a hot area of research. As a kind of drug administration for the environment, ecopharmacovigilance (EPV) emphasizes the source control of pharmaceutical pollutants. Disposal of unwanted medicines has been considered as the easiest target for source control of pharmaceutical contamination. Here, we focused on public attitudes and practice regarding disposal of unwanted medicines from the EPV perspective among 365 Chinese university young adults and 206 elderly retirement home residents. The results showed that the majority of respondents had positive attitudes, but exhibited inadequate awareness and poor practice. In addition, the young-adult respondents were found to pay more attention to the environmental problems posed by pharmaceutical residues, and be more supportive of the EPV intervention predominantly performed by pharmaceutical industries and pharmacists. Therefore, it is urgent to establish the standard medicine disposal protocols and educate the general public on the best way for medication disposal under the principle of EPV in China, and efforts on environmentally-preferred drug disposal under EPV should target for the specific demographics.

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Section: Introductionmentioning

confidence: 99%

Attitudes and Practice Regarding Disposal for Unwanted Medications among Young Adults and Elderly People in China from an Ecopharmacovigilance Perspective

et al. 2019

IJERPH

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“…anti-inflammatory/analgesic/antipyretic substances: diclofenac, ibuprofen, naproxen, ketoprofen, phenazone, salicylic acid (active metabolite of acetyl salicylic acid), paracetamol [14,15,19,22,23,27,28,30,31,33–45,47–52,54,56–58];…”

Section: Environmental Research On Medicinesmentioning

confidence: 99%

“…The occurrence of all the above-mentioned active pharmaceutical ingredients was detected in Germany, Austria, Italy, Spain, Greece, Croatia, Denmark, United Kingdom, Nederland, Switzerland, China, Brazil, the USA, Canada, Mexico, South Africa, Iraq, Saudi Arabia, India, Belgium, France, Portugal, Poland and Romania [14–24,26–58].…”

Section: Environmental Research On Medicinesmentioning

confidence: 99%

Green Pharmacy – A Narrative Review

Toma

Crişan

2018

Medicine and Pharmacy Reports

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IntroductionActive pharmaceutical ingredients are present in various sections of the environment, because of both the human and veterinary use of medicinal products. Ways of minimizing the risk of environmental contamination should be observed during all pharmaceutical activities (research, manufacturing, prescribing, dispensing and disposal of medicinal products).MethodsFor the present study we searched specific literature on this subject, using the main international databases (Thomson Reuters – Web of Science, SCOPUS and Science Direct).ResultsThis narrative review focuses on the main aspects concerning environmental contamination with medicinal products. Consequently, the present study is structured on four different topics: environmental research on medicinal products, minimizing environmental contamination, waste disposal management and towards a greener community pharmacy.ConclusionWaste management activities are important for reducing the presence of active pharmaceutical ingredients in the environment. Pharmacists should inform patients on proper pharmaceutical waste disposal and organize collection programs for unused and expired medicines, in order to develop a greener pharmacy for the future.

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“…[1][2][3][4][5] As a drug administration route on environment pollution caused by APIs, ecopharmacovigilance (EPV) is an emerging science of detection, evaluation, understanding and prevention of the adverse effects of APIs in the environment. [6][7][8][9][10][11][12][13][14] In recent years, an approach termed eco-directed sustainable prescribing (EDSP), 15 which was proposed to prevent the adverse effects of APIs in the environment resulting from medical prescriptions, has been well-accepted as an indispensable part during EPV implementation. 8 12 13 However, EDSP might conflict with long-accepted clinical prescribing guidelines and tenet.…”

Section: Introductionmentioning

confidence: 99%

Chinese physicians’ attitudes toward eco-directed sustainable prescribing from the perspective of ecopharmacovigilance: a cross-sectional study

Wang

2020

BMJ Open

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IntroductionEco-directed sustainable prescribing (EDSP) is an effective upstream way to reduce the environmental footprints of active pharmaceutical ingredients (APIs), a kind of emerging contaminants, from the patients’ excretion. EDSP is one of the key steps in the programme of ecopharmacovigilance (EPV), a drug administration route on API pollution.ObjectiveTo assess the attitudes of physicians prescribing medicines regarding EDSP from the perspective of EPV.DesignA cross-sectional study conducted from March 2019 to June 2019.Setting5 government general hospitals in Hubei province, China.Participants405 physicians were randomly selected and 262 valid questionnaires were obtained.Outcome measuresA self-developed questionnaire, which inquired about the participant characteristics, perceptions and attitudes toward API pollution, EPV and EDSP from an EPV perspective, was emailed to collect data from physicians.ResultsMost physicians agreed the existence of APIs in environment, worried about the potential environmental and ecological risks of API residues, supported the effectiveness and necessity of EDSP under an EPV perspective in decreasing environmental exposure of excreted APIs, and showed their willingness to participate in the EDSP practices. Nevertheless, no respondent identified the environmental impacts as the aspects regarding medicines affecting his(her) prescription decision, none was satisfied with knowledge on EDSP and showed confidence toward EDSP. The most important barrier to the effective implementation of EDSP was identified as ‘poor awareness of EDSP and EPV‘. Most responding physicians (97%) reported that they held the wait-and-see or conservative attitudes towards EDSP practice. The biggest concerns in low-dose prescribing and prescribing of drugs possessing environment-friendly excretion profiles, two EDSP approaches, were the possible negative impact on therapeutic outcomes and too complicated and professional drug evaluation process, respectively.ConclusionsChinese physicians had positive attitudes towards EDSP from the perspective of EPV. However, their environmental consciousness during prescribing and the related education were insufficient.

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Eco-pharmacovigilance of non-steroidal anti-inflammatory drugs: Necessity and opportunities

Cited by 96 publications

References 90 publications

Attitudes and Practice Regarding Disposal for Unwanted Medications among Young Adults and Elderly People in China from an Ecopharmacovigilance Perspective

Attitudes and Practice Regarding Disposal for Unwanted Medications among Young Adults and Elderly People in China from an Ecopharmacovigilance Perspective

Green Pharmacy – A Narrative Review

Chinese physicians’ attitudes toward eco-directed sustainable prescribing from the perspective of ecopharmacovigilance: a cross-sectional study

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