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Pharmaceutical Waste Slideshow

  1. 1. Pharmaceutical Waste Effects on Water Systems and a Healthcare Action Plan http://www.medicaldump.com/2011/09/internal-medicine-powerpoint-template.html
  2. 2. (Karnish et al., 2010)
  3. 3. What are pharmaceutical wastes? Unusable Medications Discarded Medications Medical Containers/Devices with Drug Residues http://www.sdcounty.ca.gov/deh/hazmat/hmd_pharmwaste.html/ http://www.paradiserecycles.com/aph.pir.231.html/ http://www.promo-wholesale.com/syringes.html/
  4. 4. Pharmaceutical wastes are released into water environments through... Drainage Excretion Trash http://www.gd-wholesale.com/chinaproduct/mf11d/av639to1bv/upvc-water-drainage- pipes-and-fittings-m43323.html http://globalpoliticalawakening.blogspot.com/2010/10/pharm aceutical-industrial-complex.html http://www.ecofriend.com/entry/new-eco-friendly-waste-disposal-technology- may-assist-uss-45-billion-solid-waste-management-business/
  5. 5. So…why are pharmaceutical wastes a concern to water environments and what does research have to say about it ?
  6. 6. The Concern: Concentrations Pharmaceutical Waste in Water Systems
  7. 7. Veach & Bernot, Fig.1 Water sample sites for watersheds in Indiana
  8. 8. COMPOUND CHEMICAL STRUCTURE PRIMARY USE FREQUENCEY (%) RANGES (ng/L) Sulfamethoxazole Human antibiotic 84 1.2-16 Acetaminophen Analgesic/ fever reducer 84 1.6-460 Ibuprofen NSAI/pain reliever 68 1.8-42 Carbamazepine Anticonvulsant 28 1.1-2.7 Trimethoprim Human Antibiotic 28 3-58 Triclosan Antiseptic/ disinfectant 12 9.1-22 Veach & Bernot, Table 2. Pharmaceutical frequency of detection (%) and concentration range for all analytes detected in Buck (N=13) and Killbuck Creek (N=12) combined. Analytes not detected: lincomycin,sulfathiazole, tylosin.
  9. 9. 0 20 40 60 80 100 Frequency of Detection (%) in Urban Streams Low Stream Flow Frequency of Detection (%) Koplin et al., Fig. 3, Frequency of Detection in Urban Streams
  10. 10. http://toxipedia.org/display/toxipedia/Environmental+Protection+Agency http://water.epa.gov/scitech/wastetech/guide/upload/unuseddraft.pdf
  11. 11. The Issue: Deformities Pharmaceutical Waste in Water Systems Deformations in Aquatic Life
  12. 12. frontier.cincinnati.com/mmh/cin/html That’s not what I wanted to eat! http://www.shopping.com/Walgreens- Walgreens-Ibuprofen-200-Tablets- USP-Tablets-87lb-Walgreens/info?sb=1 http://www.allegromedical.com/cold-flu-season-c5030/naproxen-sodium- caplets-p192194.html
  13. 13. Sanchez et al., Fig 4., Analysis of sex-ratio gudgeon populations from three investigated sites. * depicts a statistically significant difference as compared to the site A.
  14. 14. Sanchez et al., Fig.3, Histological analysis of gudgeon (Gobio gobio) gonads after hematoxylin-cosin-saffron staining.
  15. 15. The Issue: Unknown Health Risks Pharmaceutical Waste in Water Systems Deformations in Aquatic Life Human Health Risks?
  16. 16. Photo taken by Katelyn Duncan, Genoa WI TAKE ACTION: keep our water systems clean and safe
  17. 17. Minimization of Pharmaceutical Wastes in Water Systems Healthcare Administration Physicians Nurses Action Plan; reducing pharmaceutical wastes in aquatic systems
  18. 18. http://blog.pulsestore.com/post/2011/04/20/Some-of-the-Rewarding-Professions-in-the-Medical-Field.aspx
  19. 19. FIRST DEFENSE; HEALTH ADMINISTRATION 1. Manage disposal programs 2. Advocate to patients 3. Encourage other staff http://www.srph.tamhsc.edu/health-policy-mgmt/master-of-health-administration/index.html
  20. 20. Health Administration E A M MANAGING DISPOSAL PROGRAMS: - Recognize, Implement, or Tweak - Stay up to Date ADVOCATE TO PATIENTS: - Take-back Programs - Proper Disposal Techniques - Answer question and concerns ENCOURAGE OTHER STAFF: -Make Guidelines/Regulations Available - Oral or Visual Reminders
  21. 21. SECOND DEFENSE; PHYSICIANS 1. Prescribe drug-free therapies 2. Avoid over-prescription 3. Avoid prescribing pharmaceuticals with unsound environmental behavior http://www.parmahospital.org/PhysicianDirectory/ Note: Information in this chart was produced by Titz & Döll, 2008, p.676)
  22. 22. Physicians A A P PRESCRIBE DRUG-FREE THERAPIES -AVOID OVER PRESCRIBING AVOID PRESCRIBING PHARMACEUTICALS WITH UNSOUND ENVIRONMENTAL BEHAVIOR
  23. 23. THIRD DEFENSE; NURSES 1. Remind patients of safe disposal methods 2. Dispose of pharmaceutical wastes appropriately 3. Advocate for more research http://blog.timesunion.com/healthylife/category/nurse-appreciation-week/
  24. 24. Nurses D A R REMIND PATIENTS OF SAFE DISPOSAL METHODS: - Tell Patients Orally - Give Patients Educational Material ADVOCATE FOR MORE RESEARCH: - Contact the FDA, EPA, or Government Officials DISPOSE OF PHARMACEUTICAL WASTES APPROPRIATELY: - Check Proper Disposal Methods for Medications - Ask yourself, “How Do I Dispose of this Correctly?”
  25. 25. Is this pharmaceutical really okay to flush? http://www.porcher-us.com
  26. 26. Nurses D A R REMIND PATIENTS OF SAFE DISPOSAL METHODS: - Tell Patients Orally - Give Patients Educational Material ADVOCATE FOR MORE RESEARCH: - Contact the FDA, EPA, or Government Officials DISPOSE OF PHARMACEUTICAL WASTES APPROPRIATELY: - Check Proper Disposal Methods for Medications - Ask yourself, “How Do I Dispose of this Correctly?”
  27. 27. pbase.com, picture animation by Ernest Shaw You Can Make a Difference!
  28. 28. References Food and Drug Administration. Food and Drug Administration. (2011). How to dispose of unused medications. Retrieved from website: http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/Buyi ngUsingMedicineSafely/UnderstandingOver-the- CounterMedicines/ucm107163.pdf Karnish, Lisa and Julie Murphy. (2010). Pharmaceuticals [Video file]. Retrieved from http://www.uwec.edu/Watershed/tour/pharmaceuticals.htm Kolpin, D. , Skopec, M. , Meyer, M. , Furlong, E. , & Zaugg, S. (2004). Urban contribution of pharmaceuticals and other organic wastewater contaminants to streams during differing flow conditions. Science of the Total Environment, 328(1-3), 119-130. Lahti, M., Brozinski, J.-M., Jylhä, A., Kronberg, L. and Oikari, A. (2011), Uptake from water, biotransformation, and biliary excretion of pharmaceuticals by rainbow trout. Environmental Toxicology and Chemistry, 30: 1403-1411. Doi: 10.1002/etc.501
  29. 29. Sanchez, W., Sremski, W., Piccini, B., Palluel, O., Maillot-Marechal, E., etal. (2011). Adverse effects in wild fish living downstream from pharmaceutical manufacture dischages. Environment International, 37(8), 1342-1348. Titz, Alexandra, & Döll, Petra. (2009). Actor modeling and its contribution to the development of integrative strategies for management of pharmaceuticals in drinking water. Elsevier. Veach, V.M., & Bernot, M. J. (2011). Temporal variation of pharmaceuticals in an urban and agriculturally influenced stream. Science of the Total Environment, 4553-4563. Retreived from www.elsevier.com/locate/scitotenv Therapeutic Reserach Center. (2007). Proper disposal of expired or unwanted drugs. Pharmacists Letter; Prescribers Letter, 23(230401), 1-9. Retrieved from http://www.benzos.une.edu/documents/pharmacistslettervol23.pdf
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