The Opportunities for Minimizing the Environmental Load of PPCPs


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The Opportunities for Minimizing the Environmental Load of PPCPs

  1. 1. Green Pharmacy The Opportunities for Minimizing the Environmental Load of PPCPs Nicholas D. Anastas, Ph.D., M.S. Poseidon’s Trident, LLC Triumvirate Conference November 20, 2008
  2. 2. Overview of the Talk <ul><li>History of PPCPs in the environment </li></ul><ul><li>Lifecycle of PPCPs </li></ul><ul><li>Greening each phase of the lifecycle </li></ul><ul><li>Next steps </li></ul>
  3. 3. History of Environmental PPCPs <ul><li>Interest in environmental PPCPs has been a growing since the 1980s in Europe; more recently in U.S. (Daughton 2001). </li></ul><ul><li>Federal, state and academic groups have contributed to these advancements. </li></ul><ul><li>Daughton and others have been leading efforts in U.S. ( Toxicol. Lett ., 2002). </li></ul>
  4. 4. Increased Awareness of Environmental PPCPs <ul><li>In the scientific literature </li></ul><ul><ul><li>Kolpin et al., 2002 </li></ul></ul><ul><ul><li>Daughton, 2003 </li></ul></ul><ul><li>In the popular press </li></ul><ul><ul><li>AP five part series in March 2008 </li></ul></ul><ul><li>Response of federal and state regulatory agencies </li></ul><ul><ul><li>EPA </li></ul></ul><ul><ul><li>States </li></ul></ul>
  5. 5. Environmental side effects of medication <ul><li>Non-target effects of medicines </li></ul><ul><ul><li>Human and veterinary </li></ul></ul><ul><li>Antibiotics </li></ul><ul><ul><li>Disposal influences soil microorganisms </li></ul></ul><ul><ul><ul><li>Potential changes to metabolism </li></ul></ul></ul><ul><li>Anti-neoplastics </li></ul><ul><li>Metabolism to more active products </li></ul>
  6. 6. History of Green Pharmacy <ul><li>Green Medicine (Kreig, M., 1964) </li></ul><ul><ul><li>Ethnobotanical approach </li></ul></ul><ul><li>Green Pharmacy ( Duke, J., 1997) </li></ul><ul><ul><li>Herbal approach </li></ul></ul><ul><li>Green Pharmacy (Daughton, C., 2003) </li></ul><ul><ul><li>Environmental approach </li></ul></ul>
  7. 7. Stages of PPCP Lifecycle Discovery and development Manufacturing Distribution Prescribing Disposal
  8. 8. Discovery and Development <ul><li>Opportunities for green pharmacy </li></ul><ul><ul><li>Green chemistry </li></ul></ul><ul><ul><li>Green chemical design </li></ul></ul><ul><ul><ul><li>Improved selectivity (pharmacodynamics) </li></ul></ul></ul><ul><ul><ul><li>Quick environmental degradation to innocuous products </li></ul></ul></ul><ul><ul><li>Improved potency </li></ul></ul><ul><ul><ul><li>Enhanced absorption ( e.g., “Rule of Five”) </li></ul></ul></ul>
  9. 9. Manufacture and Distribution <ul><li>Use recycled materials when possible </li></ul><ul><li>Design packaging for biodegradability and recycling </li></ul>
  10. 10. Pill Economy <ul><li>Every pill manufactured using green design principles </li></ul><ul><li>Every pill manufactured is prescribed </li></ul><ul><li>Every pill prescribed is taken </li></ul><ul><li>Unused/unwanted pills are recycled or completely destroyed </li></ul>
  11. 11. Prescribing <ul><li>Encourage judicious prescribing </li></ul><ul><ul><li>At the heart of pill economy </li></ul></ul><ul><ul><li>Need to change the current approach in the medical profession </li></ul></ul><ul><li>Automated dispensing </li></ul><ul><ul><li>Pyxis system </li></ul></ul><ul><ul><ul><li>Prescribing prn </li></ul></ul></ul>
  12. 12. Disposal <ul><li>Flushing should be strongly discouraged </li></ul><ul><ul><li>Environmentally damaging </li></ul></ul><ul><ul><li>Encouraged for some pharmaceuticals </li></ul></ul><ul><ul><li>Must provide other options </li></ul></ul><ul><li>Incineration </li></ul><ul><li>Recycling programs </li></ul><ul><li>Take-back programs </li></ul>
  13. 13. Take-back programs <ul><li>Reverse distribution </li></ul><ul><ul><li>Pharmaceutical companies reclaim unused and out of date medications </li></ul></ul><ul><ul><ul><li>Limited to hospitals and pharmacies </li></ul></ul></ul><ul><li>Hazardous waste recycling days </li></ul><ul><li>Returns to pharmacy for residential customers </li></ul><ul><li>Mail-back programs </li></ul><ul><ul><li>Maine is a good example </li></ul></ul>
  14. 14. Environmental Pharmacy <ul><li>Taught as part of the core curriculum </li></ul><ul><ul><li>Medical schools </li></ul></ul><ul><ul><li>Schools of pharmacy </li></ul></ul><ul><ul><li>Nursing programs </li></ul></ul><ul><li>Industry examples </li></ul><ul><ul><li>Pharmaceutical roundtable (PIE) </li></ul></ul><ul><ul><li>PhATE and PhACT </li></ul></ul>
  15. 15. Opportunities for the medical community to support Green Pharmacy <ul><li>Research </li></ul><ul><ul><li>Support for the discovery and development of safer medicines </li></ul></ul><ul><li>Education </li></ul><ul><ul><li>Incorporate environmental pharmacy </li></ul></ul><ul><ul><li>Provide brochures to patients and medical staff </li></ul></ul>
  16. 16. Available Options and Tools to Encourage Green Pharmacy <ul><li>Promote the use of green chemistry </li></ul><ul><ul><li>Already part of pharmaceutical and industrial chemical manufacturer’s practices </li></ul></ul><ul><li>Change education </li></ul><ul><ul><li>Incorporate “environmental pharmacy” into the curricula </li></ul></ul><ul><ul><ul><li>Medical and pharmacy schools </li></ul></ul></ul><ul><ul><ul><li>Nursing programs </li></ul></ul></ul><ul><li>Take-back programs </li></ul>
  17. 17. Uncertainties Associated With Implementing a Green Pharmacy <ul><li>Sources </li></ul><ul><ul><li>Disposal </li></ul></ul><ul><ul><li>Excretion </li></ul></ul><ul><li>Occurrence </li></ul><ul><ul><li>National vs. local data </li></ul></ul><ul><li>Treatment </li></ul><ul><li>Hazard assessment </li></ul><ul><li>Fate and transport </li></ul>
  18. 18. Conclusions <ul><li>The practice of “green pharmacy” has already begun </li></ul><ul><li>Green pharmacy is a holistic approach to reducing the environmental load of PPCPs </li></ul>