Modern Medicines in Drinking Water

[Guest guest]

Dear Dr Bharat, Medicines can come in drinking water if medicines are disposed off just like that near hospital water sources. Modern day packaged water also could contain pesticides (which are added to prevent any fungal contamination in bottles). Unknowingly, we could be exposed to plenty of medicines through drinking water. The amount of chlorine added to drinking water could be in excess. -Anupama Bharat Gajjar <gajjarbm@...> wrote: Dear friends,Welcome you all for lively discussion on the new topic'Modern Medicines in Drinking Water'.Let us start from the basic.-What do we mean by the term 'Xenobiotics'?-Which substances can be included under the umbrellaof 'Xenobiotics'?-Modern medicines in drinking water! Looking strange?Is it possible? If yes, how it is possible? Anybenefit or harm due to presence of medicines in water?Bharat Gajjar.--- Vijay <drvijaythawani (DOT) co.in> wrote:> > Hi,> > On behalf of NetRUM I am honoured to extend heart> felt thanks to Dr> Anupama Sucklecha for moderating the discussion on> "Doping in sports "> from 01 to 07 April 2008.> > For the next E-discussion on NetRUM hearty welcome> to Dr Bharat

Gajjar> for moderating discussion on "Modern medicines in> drinking water" which> will run from 09 April through 16 April 2008.> > Dr Bharat please take over.> > Vijay> > Groupie> > > __________________________________________________________You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost. http://tc.deals./tc/blockbuster/text5.com

Did you know? You can CHAT without downloading messenger. Click here

[Guest guest]

Hi

The topic is indeed new and I honestly admit that I have not any

home wrok on it so far.

Kinetically, what ever medicines humans and animals excrete, if the

untreated excetory products are sent to environment, these can end

up contaminating the water and food chain.

In bio-medical waste (BMW) management separate sewage system is

recommended for facilities where radio active (RA) medicines are

administered to patients. But all hospital drains open in municipal

drainage system and for sure the RA medicines must be contaminating

water table.

Dead patients suffering from carcinoma, who received

chemotherapeutic medication, whether cremated by burning or burial,

take the medicines to land and in turn due to the long half lives,

affect the ecology.

The practice of immersing ashes of the dead of the dead in flowing

streams is sure to fascilitate dispersion of medicines which are not

destroyed by incineration when dead bodies are burnt.

In BMW management the ash is considered highly toxic and special

treatment facilities like encapsulation in stainless steel

containers, deep burial in fenced, animal proof, thick walled

concrete pits is adviced.

I am also aware that some microbes in the soil actually survive and

thrive on the antimicobials which are excreted.

Use of chemical warfare agents, antiseptics, disinfectants,

pesticides, rodenticides, insecticides - all contaminate water.

I await enlightenment from the moderator.

Vijay Thawani

>

> >

> > Hi,

> >

> > On behalf of NetRUM I am honoured to extend heart

> > felt thanks to Dr

> > Anupama Sucklecha for moderating the discussion on

> > " Doping in sports "

> > from 01 to 07 April 2008.

> >

> > For the next E-discussion on NetRUM hearty welcome

> > to Dr Bharat Gajjar

> > for moderating discussion on " Modern medicines in

> > drinking water " which

> > will run from 09 April through 16 April 2008.

> >

> > Dr Bharat please take over.

> >

> > Vijay

> >

> > Groupie

> >

> >

> >

>

>

>

>

_____________________________________________________________________

_______________

> You rock. That's why Blockbuster's offering you one month of

Blockbuster Total Access, No Cost.

> http://tc.deals./tc/blockbuster/text5.com

>

[Guest guest]

Dear Dr. Anupama and Vijay,

Thank you for making the ball to roll.

Indeed it is a new topic,but it is not out of our

imagination, experience and thinking.This has been

proved by Dr. Vijay.

A xenobiotic (from the Greek words

xenos:stranger/foreign and bios:life) is a chemical

which is found in an organism but which is not

normally produced or expected to be present in it. It

can also cover substances which are present in much

higher concentrations than are usual.

Specifically, drugs such as antibiotics are

xenobiotics in humans because the human body does not

produce them itself nor would they be expected to be

present as part of a normal diet.

Xenobiotisc may include modern medicines,

complementary and alternative medicines,

cosmetics,agricultural products,certain food and

nutrients,chemicals used for

torture,interrogation,judicial

execution,euthanasia,medicines used in

sports(doping)and abuse drugs.

Drugs most commonly enter the environment in two ways:

Humans pass medicines and supplements through their

system.

Unwanted drugs are improperly disposed of in the

toilet or trash.

Obviously,there are no such studies in India.

US and other countries face this problem and they have

started studying the problem,its environmental impact

and remedial measures.

What can be the hazards of 'Medicines in water' for

aquatic and human life?

Bharat Gajjar.

--- Vijay <drvijaythawani@...> wrote:

> Hi

>

> The topic is indeed new and I honestly admit that I

> have not any

> home wrok on it so far.

>

> Kinetically, what ever medicines humans and animals

> excrete, if the

> untreated excetory products are sent to environment,

> these can end

> up contaminating the water and food chain.

>

> In bio-medical waste (BMW) management separate

> sewage system is

> recommended for facilities where radio active (RA)

> medicines are

> administered to patients. But all hospital drains

> open in municipal

> drainage system and for sure the RA medicines must

> be contaminating

> water table.

>

> Dead patients suffering from carcinoma, who received

>

> chemotherapeutic medication, whether cremated by

> burning or burial,

> take the medicines to land and in turn due to the

> long half lives,

> affect the ecology.

>

> The practice of immersing ashes of the dead of the

> dead in flowing

> streams is sure to fascilitate dispersion of

> medicines which are not

> destroyed by incineration when dead bodies are

> burnt.

>

> In BMW management the ash is considered highly toxic

> and special

> treatment facilities like encapsulation in stainless

> steel

> containers, deep burial in fenced, animal proof,

> thick walled

> concrete pits is adviced.

>

> I am also aware that some microbes in the soil

> actually survive and

> thrive on the antimicobials which are excreted.

>

> Use of chemical warfare agents, antiseptics,

> disinfectants,

> pesticides, rodenticides, insecticides - all

> contaminate water.

>

> I await enlightenment from the moderator.

>

> Vijay Thawani

>

>

> >

> > >

> > > Hi,

> > >

> > > On behalf of NetRUM I am honoured to extend

> heart

> > > felt thanks to Dr

> > > Anupama Sucklecha for moderating the discussion

> on

> > > " Doping in sports "

> > > from 01 to 07 April 2008.

> > >

> > > For the next E-discussion on NetRUM hearty

> welcome

> > > to Dr Bharat Gajjar

> > > for moderating discussion on " Modern medicines

> in

> > > drinking water " which

> > > will run from 09 April through 16 April 2008.

> > >

> > > Dr Bharat please take over.

> > >

> > > Vijay

> > >

> > > Groupie

> > >

> > >

> > >

> >

> >

> >

> >

>

_____________________________________________________________________

> _______________

> > You rock. That's why Blockbuster's offering you

> one month of

> Blockbuster Total Access, No Cost.

> > http://tc.deals./tc/blockbuster/text5.com

> >

>

>

>

__________________________________________________

[Guest guest]

-Indeed its a interesting topic to ponder over and we as doctors

dont think about it.I thank Dr.Anupama & Dr.Vijay for intiating such

a topic .Great addition given by Dr.Gajjar about Xenobiotics

-- In netrum , Bharat Gajjar <gajjarbm@...> wrote:

>

> Dear Dr. Anupama and Vijay,

> Thank you for making the ball to roll.

> Indeed it is a new topic,but it is not out of our

> imagination, experience and thinking.This has been

> proved by Dr. Vijay.

> A xenobiotic (from the Greek words

> xenos:stranger/foreign and bios:life) is a chemical

> which is found in an organism but which is not

> normally produced or expected to be present in it. It

> can also cover substances which are present in much

> higher concentrations than are usual.

> Specifically, drugs such as antibiotics are

> xenobiotics in humans because the human body does not

> produce them itself nor would they be expected to be

> present as part of a normal diet.

> Xenobiotisc may include modern medicines,

> complementary and alternative medicines,

> cosmetics,agricultural products,certain food and

> nutrients,chemicals used for

> torture,interrogation,judicial

> execution,euthanasia,medicines used in

> sports(doping)and abuse drugs.

> Drugs most commonly enter the environment in two ways:

>

> Humans pass medicines and supplements through their

> system.

> Unwanted drugs are improperly disposed of in the

> toilet or trash.

> Obviously,there are no such studies in India.

> US and other countries face this problem and they have

> started studying the problem,its environmental impact

> and remedial measures.

> What can be the hazards of 'Medicines in water' for

> aquatic and human life?

> Bharat Gajjar.

> --- Vijay <drvijaythawani@...> wrote:

>

> > Hi

> >

> > The topic is indeed new and I honestly admit that I

> > have not any

> > home wrok on it so far.

> >

> > Kinetically, what ever medicines humans and animals

> > excrete, if the

> > untreated excetory products are sent to environment,

> > these can end

> > up contaminating the water and food chain.

> >

> > In bio-medical waste (BMW) management separate

> > sewage system is

> > recommended for facilities where radio active (RA)

> > medicines are

> > administered to patients. But all hospital drains

> > open in municipal

> > drainage system and for sure the RA medicines must

> > be contaminating

> > water table.

> >

> > Dead patients suffering from carcinoma, who received

> >

> > chemotherapeutic medication, whether cremated by

> > burning or burial,

> > take the medicines to land and in turn due to the

> > long half lives,

> > affect the ecology.

> >

> > The practice of immersing ashes of the dead of the

> > dead in flowing

> > streams is sure to fascilitate dispersion of

> > medicines which are not

> > destroyed by incineration when dead bodies are

> > burnt.

> >

> > In BMW management the ash is considered highly toxic

> > and special

> > treatment facilities like encapsulation in stainless

> > steel

> > containers, deep burial in fenced, animal proof,

> > thick walled

> > concrete pits is adviced.

> >

> > I am also aware that some microbes in the soil

> > actually survive and

> > thrive on the antimicobials which are excreted.

> >

> > Use of chemical warfare agents, antiseptics,

> > disinfectants,

> > pesticides, rodenticides, insecticides - all

> > contaminate water.

> >

> > I await enlightenment from the moderator.

> >

> > Vijay Thawani

> >

> >

> > >

> > > >

> > > > Hi,

> > > >

> > > > On behalf of NetRUM I am honoured to extend

> > heart

> > > > felt thanks to Dr

> > > > Anupama Sucklecha for moderating the discussion

> > on

> > > > " Doping in sports "

> > > > from 01 to 07 April 2008.

> > > >

> > > > For the next E-discussion on NetRUM hearty

> > welcome

> > > > to Dr Bharat Gajjar

> > > > for moderating discussion on " Modern medicines

> > in

> > > > drinking water " which

> > > > will run from 09 April through 16 April 2008.

> > > >

> > > > Dr Bharat please take over.

> > > >

> > > > Vijay

> > > >

> > > > Groupie

> > > >

> > > >

> > > >

> > >

> > >

> > >

> > >

> >

>

_____________________________________________________________________

> > _______________

> > > You rock. That's why Blockbuster's offering you

> > one month of

> > Blockbuster Total Access, No Cost.

> > > http://tc.deals./tc/blockbuster/text5.com

> > >

> >

> >

> >

>

>

> __________________________________________________

>

[Guest guest]

Hi, That seems an interesting topic. I think you can get a good resource for your seminar at Karamsad from this discussion. Dr S Z Rahman has written an editorial in IJP on this topic. The well known example is Minamata disease in Japan which occured because of fishes dying after consuming water contaminated with mercury. Do pharmaceutical industries comply to regulations for waste management? In Ahmedabad-Vatwa area, I have seen a river (or a drain!) full of black stinking water coming from pharma and other industries nearby. Is there a laboratory method of finding the medicines in water and removing them from drinking water? -AnupamaBharat Gajjar <gajjarbm@...> wrote: Dear Dr. Anupama and Vijay,Thank you for making the ball to roll.Indeed it is a new topic,but it is not out of ourimagination, experience and thinking.This has beenproved by Dr. Vijay.A xenobiotic (from the Greek wordsxenos:stranger/foreign and bios:life) is a chemicalwhich is found in an organism but which is notnormally produced or expected to be present in it. Itcan also cover substances which are present in muchhigher concentrations than are usual.Specifically, drugs such as antibiotics arexenobiotics in humans because the human body does notproduce them itself nor would they be expected to bepresent as part of a normal diet.Xenobiotisc

may include modern medicines,complementary and alternative medicines,cosmetics,agricultural products,certain food andnutrients,chemicals used fortorture,interrogation,judicialexecution,euthanasia,medicines used insports(doping)and abuse drugs. Drugs most commonly enter the environment in two ways:Humans pass medicines and supplements through theirsystem. Unwanted drugs are improperly disposed of in thetoilet or trash. Obviously,there are no such studies in India.US and other countries face this problem and they havestarted studying the problem,its environmental impactand remedial measures.What can be the hazards of 'Medicines in water' foraquatic and human life?Bharat Gajjar.--- Vijay <drvijaythawani (DOT) co.in> wrote:> Hi > > The topic is indeed new and I honestly admit that

I> have not any > home wrok on it so far.> > Kinetically, what ever medicines humans and animals> excrete, if the > untreated excetory products are sent to environment,> these can end > up contaminating the water and food chain.> > In bio-medical waste (BMW) management separate> sewage system is > recommended for facilities where radio active (RA)> medicines are > administered to patients. But all hospital drains> open in municipal > drainage system and for sure the RA medicines must> be contaminating > water table.> > Dead patients suffering from carcinoma, who received> > chemotherapeutic medication, whether cremated by> burning or burial, > take the medicines to land and in turn due to the> long half lives, > affect the ecology. > > The practice of immersing ashes of the dead

of the> dead in flowing > streams is sure to fascilitate dispersion of> medicines which are not > destroyed by incineration when dead bodies are> burnt.> > In BMW management the ash is considered highly toxic> and special > treatment facilities like encapsulation in stainless> steel > containers, deep burial in fenced, animal proof,> thick walled > concrete pits is adviced. > > I am also aware that some microbes in the soil> actually survive and > thrive on the antimicobials which are excreted.> > Use of chemical warfare agents, antiseptics,> disinfectants, > pesticides, rodenticides, insecticides - all> contaminate water.> > I await enlightenment from the moderator.> > Vijay Thawani> > > > > > > > > > Hi,> > > > > > On behalf of NetRUM I am honoured to extend> heart> > > felt thanks to Dr> > > Anupama Sucklecha for moderating the

discussion> on> > > "Doping in sports "> > > from 01 to 07 April 2008.> > > > > > For the next E-discussion on NetRUM hearty> welcome> > > to Dr Bharat Gajjar> > > for moderating discussion on "Modern medicines> in> > > drinking water" which> > > will run from 09 April through 16 April 2008.> > > > > > Dr Bharat please take over.> > > > > > Vijay> > > > > > Groupie> > > > > > > > > > > > > > > > > >__________________________________________________________> _______________> > You rock. That's why Blockbuster's offering you> one month of > Blockbuster Total Access, No Cost. > > http://tc.deals./tc/blockbuster/text5.com> >> > > __________________________________________________

[Guest guest]

A xenobiotic (from the Greek words

xenos:stranger/foreign and bios:life) is a chemical

which is found in an organism but which is not

normally produced or expected to be present in it. It

can also cover substances which are present in much

higher concentrations than are usual.

Specifically, drugs such as antibiotics are

xenobiotics in humans because the human body does not

produce them itself nor would they be expected to be

present as part of a normal diet. However, the term is

also used in the context of pollutants such as dioxins

and polychlorinated biphenyls and their effect on the

biota. Natural compounds can also become xenobiotics

if they are taken up by another organism, such as the

uptake of natural human hormones by fish found

downstream of sewage treatment plant outfalls, or the

chemical defenses produced by some organisms as

protection against predators.

some xenobiotics can induce apoptosis at lower doses

and necrosis at higher doses. xenobiotics at low

concentration can induce precommited reversible

apoptotic phase which is followed by irreversible

apoptotic phase.

Xenobiotic metabolism

The body removes xenobiotics by xenobiotic metabolism.

This consists of the deactivation and the secretion of

xenobiotics, and happens mostly in the liver.

Secretion routes are urine, feces, breath, and sweat.

Hepatic enzymes are responsible for the metabolism of

xenobiotics by first activating them (oxidation,

reduction, hydrolysis and/or hydration of the

xenobiotic), and then conjugating the active secondary

metabolite with glucuronic or sulphuric acid, or

glutathione, followed by excretion in bile or urine.

An example of a group of enzymes involved in

xenobiotic metabolism is hepatic microsomal cytochrome

P450. These enzymes that metabolize xenobiotics are

very important for the pharmaceutical industry,

because they are responsible for the breakdown of

medications.

Organisms can also evolve to tolerate xenobiotics. An

example is the co-evolution of the production of

tetrodotoxin in the rough-skinned newt and the

evolution of tetrodotoxin resistance in its predator,

the common garter snake. In this predator-prey pair,

an evolutionary arms race has produced high levels of

toxin in the newt and correspondingly high levels of

resistance in the snake.[1] This evolutionary response

is based on the snake evolving modified forms of the

ion channels that the toxin acts upon, so becoming

resistant to its effects.[2]

Xenobiotics in the environment

Xenobiotic substances are becoming an increasingly

large problem in Sewage Treatment systems, since they

are relatively new substances and are very difficult

to categorize. Antibiotics, for example, were derived

from plants originally, and so mimic naturally

occurring substances. This, along with the natural

monopoly nature of municipal Waste Water Treatment

Plants makes it nearly impossible to remove this new

pollutant load.

Some xenobiotics are resistant to degradation. For

example, they may be synthetic organochlorides such as

plastics and pesticides, or naturally occurring

organic chemicals such as polyaromatic hydrocarbons

(PAHs) and some fractions of crude oil and coal.

However, it is believed that microorganisms are

capable of degrading all the different complex and

resistant xenobiotics found on the earth.

Inter-species organ transplantation

The term xenobiotic is also used to refer to organs

transplanted from one species to another. For example,

some researchers hope that hearts and other organs

could be transplanted from pigs to humans. Many people

die every year whose lives could have been saved if a

critical organ had been available for transplant.

Kidneys are currently the most commonly transplanted

organ. Xenobiotic organs would need to be developed in

such a way that they would not be rejected by the

immune system. With the development of vitrification

transplantable organs could be stored in organ banks

for long periods.

References

1. Brodie ED, Ridenhour BJ, Brodie ED (2002). " The

evolutionary response of predators to dangerous prey:

hotspots and coldspots in the geographic mosaic of

coevolution between garter snakes and newts " .

Evolution 56 (10): 2067–82. PMID 12449493.

2. ^ Geffeney S, Brodie ED, PC, Brodie ED

(2002). " Mechanisms of adaptation in a predator-prey

arms race: TTX-resistant sodium channels " . Science 297

(5585): 1336–9. PMID 12193784.

--- Bharat Gajjar <gajjarbm@...> wrote:

> Dear friends,

> Welcome you all for lively discussion on the new

> topic

> 'Modern Medicines in Drinking Water'.

> Let us start from the basic.

> -What do we mean by the term 'Xenobiotics'?

> -Which substances can be included under the umbrella

> of 'Xenobiotics'?

> -Modern medicines in drinking water! Looking

> strange?

> Is it possible? If yes, how it is possible? Any

> benefit or harm due to presence of medicines in

> water?

> Bharat Gajjar.

>

> --- Vijay <drvijaythawani@...> wrote:

>

> >

> > Hi,

> >

> > On behalf of NetRUM I am honoured to extend heart

> > felt thanks to Dr

> > Anupama Sucklecha for moderating the discussion on

> > " Doping in sports "

> > from 01 to 07 April 2008.

> >

> > For the next E-discussion on NetRUM hearty welcome

> > to Dr Bharat Gajjar

> > for moderating discussion on " Modern medicines in

> > drinking water " which

> > will run from 09 April through 16 April 2008.

> >

> > Dr Bharat please take over.

> >

> > Vijay

> >

> > Groupie

> >

> >

> >

>

>

>

>

>

________________________________________________________________________________\

____

> You rock. That's why Blockbuster's offering you one

> month of Blockbuster Total Access, No Cost.

> http://tc.deals./tc/blockbuster/text5.com

>

Send instant messages to your online friends http://uk.messenger.

[Guest guest]

Xenobiotics are chemicals found in organisms, but not

expected to be produced or present in them; or they

are chemicals found in much higher concentrations than

usual. Organs transplanted cross-species are also

called xenobiotic.

An example of a xenobiotic is an antibiotic; the human

body does not produce them, and they are not expected

to be present in the normal human diet. It is more

commonly used to describe dioxins and polychlorinated

biphenyls, which affect biological organisms in a

variety of ways both fatal and nonfatal.

Xenobiotics are eliminated from the body through

xenobiotic metabolism, in which the xenobiotic is

deactivated and secreted away from the body. The liver

is typically the primary focus of xenobiotic

metabolism, and secretion can occur through urine,

feces, breath, and sweat. Hepatic enzymes metabolize

xenobiotics. An understanding of xenobiotic

metabolites is critical for the pharmaceutical

industry because they are responsible for the

breakdown of drugs.

--- Bharat Gajjar <gajjarbm@...> wrote:

> Dear friends,

> Welcome you all for lively discussion on the new

> topic

> 'Modern Medicines in Drinking Water'.

> Let us start from the basic.

> -What do we mean by the term 'Xenobiotics'?

> -Which substances can be included under the umbrella

> of 'Xenobiotics'?

> -Modern medicines in drinking water! Looking

> strange?

> Is it possible? If yes, how it is possible? Any

> benefit or harm due to presence of medicines in

> water?

> Bharat Gajjar.

>

> --- Vijay <drvijaythawani@...> wrote:

>

> >

> > Hi,

> >

> > On behalf of NetRUM I am honoured to extend heart

> > felt thanks to Dr

> > Anupama Sucklecha for moderating the discussion on

> > " Doping in sports "

> > from 01 to 07 April 2008.

> >

> > For the next E-discussion on NetRUM hearty welcome

> > to Dr Bharat Gajjar

> > for moderating discussion on " Modern medicines in

> > drinking water " which

> > will run from 09 April through 16 April 2008.

> >

> > Dr Bharat please take over.

> >

> > Vijay

> >

> > Groupie

> >

> >

> >

>

>

>

>

>

________________________________________________________________________________\

____

> You rock. That's why Blockbuster's offering you one

> month of Blockbuster Total Access, No Cost.

> http://tc.deals./tc/blockbuster/text5.com

>

Send instant messages to your online friends http://uk.messenger.

[Guest guest]

hello all

pardon me sir, but i fail to understand why the chemicals found in drinking water are being referred to as medicines?

you have given a very clear idea that medicines are metabolised in the body and then only the inactive metabolites are excreted in urine/feces. (barring of course some metabolites which are active in the medicine sense). we all are aware of the arsenic.mercury, and trace minerals present beyond permissible limits in drinking water.We also know about radioactive material in waste water.But medicines in drinking water is a very nerve shattering idea.

Can we have some data of having found some medicine in drinking water.So next time I buy mineral water , I will surely think about this .

kunda> Hi > > The topic is indeed new and I honestly admit that I> have not any > home wrok on it so far.> > Kinetically, what ever medicines humans and animals> excrete, if the > untreated excetory products are sent to environment,> these can end

> up contaminating the water and food chain.> > In bio-medical waste (BMW) management separate> sewage system is > recommended for facilities where radio active (RA)> medicines are > administered to patients. But all hospital drains> open in municipal > drainage system and for sure the RA medicines must> be contaminating > water table.> > Dead patients suffering from carcinoma, who received> > chemotherapeutic medication, whether cremated by> burning or burial, > take the medicines to land and in turn due to the> long half lives, > affect the ecology. > > The practice of immersing ashes of the dead of the> dead in flowing > streams is sure to fascilitate dispersion of> medicines which are not > destroyed by incineration when dead bodies are> burnt.> > In BMW

management the ash is considered highly toxic> and special > treatment facilities like encapsulation in stainless> steel > containers, deep burial in fenced, animal proof,> thick walled > concrete pits is adviced. > > I am also aware that some microbes in the soil> actually survive and > thrive on the antimicobials which are excreted.> > Use of chemical warfare agents, antiseptics,> disinfectants, > pesticides, rodenticides, insecticides - all> contaminate water.> > I await enlightenment from the moderator.> > Vijay Thawani> > > > > > > > > > Hi,> > > > > > On behalf of NetRUM I am honoured to extend> heart> > > felt thanks to Dr> > > Anupama Sucklecha for moderating the discussion> on> > > "Doping in sports "> > > from 01 to 07 April 2008..> > > > > > For the next E-discussion on

NetRUM hearty> welcome> > > to Dr Bharat Gajjar> > > for moderating discussion on "Modern medicines> in> > > drinking water" which> > > will run from 09 April through 16 April 2008.> > > > > > Dr Bharat please take over.> > > > > > Vijay> > > > > > Groupie> > > > > > > > > > > > > > > > > >____________ _________ _________ _________ _________ _________ _> ____________ ___> > You rock. That's why Blockbuster' s offering you> one month of > Blockbuster Total Access, No Cost. > > http://tc.deals. / tc/blockbuster/ text5..com> >> > > ____________

_________ _________ _________ _________ __

[Guest guest]

Dear Anupama,

Thank you for your input.

'I think you can get a good resource for your seminar

at Karamsad from this discussion.'

What is the meaning of this statement?

Our week celebration is about to finish.

We are preparing on the topic of 'xenobiotics' from

last seven months.We have already done a week-long

function for high-school students six months back.

The purpose of this discussion is to share the ideas

and generate awareness among our colleagues.

Bharat Gajjar.

- anupama sukhlecha <anupama_acad@...> wrote:

> Hi,

> That seems an interesting topic. I think you can

> get a good resource for your seminar at Karamsad

> from this discussion.

> Dr S Z Rahman has written an editorial in IJP on

> this topic.

> The well known example is Minamata disease in

> Japan which occured because of fishes dying after

> consuming water contaminated with mercury.

> Do pharmaceutical industries comply to

> regulations for waste management? In Ahmedabad-Vatwa

> area, I have seen a river (or a drain!) full of

> black stinking water coming from pharma and other

> industries nearby.

> Is there a laboratory method of finding the

> medicines in water and removing them from drinking

> water?

> -Anupama

>

> Bharat Gajjar <gajjarbm@...> wrote:

> Dear Dr. Anupama and Vijay,

> Thank you for making the ball to roll.

> Indeed it is a new topic,but it is not out of our

> imagination, experience and thinking.This has been

> proved by Dr. Vijay.

> A xenobiotic (from the Greek words

> xenos:stranger/foreign and bios:life) is a chemical

> which is found in an organism but which is not

> normally produced or expected to be present in it.

> It

> can also cover substances which are present in much

> higher concentrations than are usual.

> Specifically, drugs such as antibiotics are

> xenobiotics in humans because the human body does

> not

> produce them itself nor would they be expected to be

> present as part of a normal diet.

> Xenobiotisc may include modern medicines,

> complementary and alternative medicines,

> cosmetics,agricultural products,certain food and

> nutrients,chemicals used for

> torture,interrogation,judicial

> execution,euthanasia,medicines used in

> sports(doping)and abuse drugs.

> Drugs most commonly enter the environment in two

> ways:

>

> Humans pass medicines and supplements through their

> system.

> Unwanted drugs are improperly disposed of in the

> toilet or trash.

> Obviously,there are no such studies in India.

> US and other countries face this problem and they

> have

> started studying the problem,its environmental

> impact

> and remedial measures.

> What can be the hazards of 'Medicines in water' for

> aquatic and human life?

> Bharat Gajjar.

> --- Vijay <drvijaythawani@...> wrote:

>

> > Hi

> >

> > The topic is indeed new and I honestly admit that

> I

> > have not any

> > home wrok on it so far.

> >

> > Kinetically, what ever medicines humans and

> animals

> > excrete, if the

> > untreated excetory products are sent to

> environment,

> > these can end

> > up contaminating the water and food chain.

> >

> > In bio-medical waste (BMW) management separate

> > sewage system is

> > recommended for facilities where radio active (RA)

> > medicines are

> > administered to patients. But all hospital drains

> > open in municipal

> > drainage system and for sure the RA medicines must

> > be contaminating

> > water table.

> >

> > Dead patients suffering from carcinoma, who

> received

> >

> > chemotherapeutic medication, whether cremated by

> > burning or burial,

> > take the medicines to land and in turn due to the

> > long half lives,

> > affect the ecology.

> >

> > The practice of immersing ashes of the dead of the

> > dead in flowing

> > streams is sure to fascilitate dispersion of

> > medicines which are not

> > destroyed by incineration when dead bodies are

> > burnt.

> >

> > In BMW management the ash is considered highly

> toxic

> > and special

> > treatment facilities like encapsulation in

> stainless

> > steel

> > containers, deep burial in fenced, animal proof,

> > thick walled

> > concrete pits is adviced.

> >

> > I am also aware that some microbes in the soil

> > actually survive and

> > thrive on the antimicobials which are excreted.

> >

> > Use of chemical warfare agents, antiseptics,

> > disinfectants,

> > pesticides, rodenticides, insecticides - all

> > contaminate water.

> >

> > I await enlightenment from the moderator.

> >

> > Vijay Thawani

> >

> >

> > >

> > > >

> > > > Hi,

> > > >

> > > > On behalf of NetRUM I am honoured to extend

> > heart

> > > > felt thanks to Dr

> > > > Anupama Sucklecha for moderating the

> discussion

> > on

> > > > " Doping in sports "

> > > > from 01 to 07 April 2008.

> > > >

> > > > For the next E-discussion on NetRUM hearty

> > welcome

> > > > to Dr Bharat Gajjar

> > > > for moderating discussion on " Modern medicines

> > in

> > > > drinking water " which

> > > > will run from 09 April through 16 April 2008.

> > > >

> > > > Dr Bharat please take over.

> > > >

> > > > Vijay

> > > >

> > > > Groupie

> > > >

> > > >

> > > >

> > >

> > >

> > >

> > >

> >

>

__________________________________________________________

> > _______________

> > > You rock. That's why Blockbuster's offering you

> > one month of

> > Blockbuster Total Access, No Cost.

> > >

> http://tc.deals./tc/blockbuster/text5.com

> > >

> >

> >

> >

>

> __________________________________________________

>

[Guest guest]

Hi Kunda Madam,

Good question!

Why the chemicals found in drinking water are being

referred to as medicines?

Please refer this.

Drugs most commonly enter the environment in two ways:

Humans pass medicines and supplements through their

system.

Unwanted drugs are improperly disposed of in the

toilet or trash.

As I have said that no data is available from our

country.

Some US data:

Prescription drug use is on the rise!

Between 2000 through 2004, the number of

pharmaceutical prescriptions increased 109%. On

average, each American was given 10.9 prescriptions

per year. This increasing reliance on pharmaceuticals

suggests a growing number of unused drugs in

households across the U.S. Did you know 40% of

medicines prescribed and purchased in the U.S. have

never been used! In 2007, the elderly population alone

will waste over $1 billion on unused drugs. Nearly

every home in America has a stockpile of unwanted

medicines.

Why do drugs go unused?

-Drugs expire or are outdated

-Doctor discontinues drug

-Doctor orders new drug

-Patients feel better

-Adverse or allergic reaction

-Patient dies or moves away

-Patients stop taking it

-Doctors prescribe too many pills

What is the position in our country regarding unused

drugs?

Bharat Gajjar.

--- kunda gharpure <gharpurekunda@...> wrote:

---------------------------------

hello all

pardon me sir, but i fail to understand why the

chemicals found in drinking water are being referred

to as medicines?

you have given a very clear idea that medicines are

metabolised in the body and then only the inactive

metabolites are excreted in urine/feces. (barring of

course some metabolites which are active in the

medicine sense). we all are aware of the

arsenic.mercury, and trace minerals present beyond

permissible limits in drinking water.We also know

about radioactive material in waste water.But

medicines in drinking water is a very nerve shattering

idea.

Can we have some data of having found some medicine

in drinking water.So next time I buy mineral water , I

will surely think about this .

kunda

> Hi

>

> The topic is indeed new and I honestly admit that I

> have not any

> home wrok on it so far.

>

> Kinetically, what ever medicines humans and animals

> excrete, if the

> untreated excetory products are sent to environment,

> these can end

> up contaminating the water and food chain.

>

> In bio-medical waste (BMW) management separate

> sewage system is

> recommended for facilities where radio active (RA)

> medicines are

> administered to patients. But all hospital drains

> open in municipal

> drainage system and for sure the RA medicines must

> be contaminating

> water table.

>

> Dead patients suffering from carcinoma, who received

>

> chemotherapeutic medication, whether cremated by

> burning or burial,

> take the medicines to land and in turn due to the

> long half lives,

> affect the ecology.

>

> The practice of immersing ashes of the dead of the

> dead in flowing

> streams is sure to fascilitate dispersion of

> medicines which are not

> destroyed by incineration when dead bodies are

> burnt.

>

> In BMW management the ash is considered highly toxic

> and special

> treatment facilities like encapsulation in stainless

> steel

> containers, deep burial in fenced, animal proof,

> thick walled

> concrete pits is adviced.

>

> I am also aware that some microbes in the soil

> actually survive and

> thrive on the antimicobials which are excreted.

>

> Use of chemical warfare agents, antiseptics,

> disinfectants,

> pesticides, rodenticides, insecticides - all

> contaminate water.

>

> I await enlightenment from the moderator.

>

> Vijay Thawani

>

>

> >

> > >

> > > Hi,

> > >

> > > On behalf of NetRUM I am honoured to extend

> heart

> > > felt thanks to Dr

> > > Anupama Sucklecha for moderating the discussion

> on

> > > " Doping in sports "

> > > from 01 to 07 April 2008..

> > >

> > > For the next E-discussion on NetRUM hearty

> welcome

> > > to Dr Bharat Gajjar

> > > for moderating discussion on " Modern medicines

> in

> > > drinking water " which

> > > will run from 09 April through 16 April 2008.

> > >

> > > Dr Bharat please take over.

> > >

> > > Vijay

> > >

> > > Groupie

> > >

> > >

> > >

> >

> >

> >

> >

>

____________ _________ _________ _________ _________

_________ _

> ____________ ___

> > You rock. That's why Blockbuster' s offering you

> one month of

> Blockbuster Total Access, No Cost.

> > http://tc.deals. / tc/blockbuster/

text5..com

> >

>

>

>

____________ _________ _________ _________ _________

__

[Guest guest]

Hi NetRUMians,

1. Please desist from making any personal remarks on NetRUM and ensure that the ground rule of quality posting is followed.

2. All moderators should be shown due respect since they are more knowledgable in the subject and give their free services to NetRUM.

3. Let us not forget that the freedom of expression through unedited postings will continue, if the same is not misued.

4. The member must identify self at the end of the post.

5. No invitations for viewing own albums etc on NetRUM please.

VijayGroupie> > > > > > > > > > > > > > Hi,> > > > > > > > > > On behalf of NetRUM I am honoured to extend> > > heart> > > > > felt thanks to Dr> > > > > Anupama Sucklecha for moderating the> > discussion> > > on> > > > > "Doping in sports "> > > > > from 01 to 07 April 2008.> > > > > > > > > > For the next E-discussion on NetRUM hearty> > > welcome> > > > > to Dr Bharat Gajjar> > > > > for moderating discussion on "Modern medicines> > > in> > > > > drinking water" which> > > > > will run from 09 April through 16 April 2008.> > > > > > > > > > Dr Bharat please take over.> > > > > > > > > > Vijay> > > > > > > > > > Groupie> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> >> __________________________________________________________> > > _______________> > > > You rock. That's why Blockbuster's offering you> > > one month of > > > Blockbuster Total Access, No Cost. > > > >> > http://tc.deals./tc/blockbuster/text5.com> > > >> > > > > > > > > > > > > __________________________________________________> >

[Guest guest]

Dear Dr Bharat and Dr Vijay, I am sorry if you were hurt by any of the statements I made. I didn't mean anything in personal sense.I respect all my seniors and always seek their blessings. Sorry once again. -Anupama Vijay <drvijaythawani@...> wrote: Hi NetRUMians, 1. Please desist from making any personal remarks on NetRUM and ensure that the ground rule of quality posting is

followed. 2. All moderators should be shown due respect since they are more knowledgable in the subject and give their free services to NetRUM. 3. Let us not forget that the freedom of expression through unedited postings will continue, if the same is not misued. 4. The member must identify self at the end of the post. 5. No invitations for viewing own albums etc on NetRUM please. VijayGroupie> > > > > > > > > > > > > > Hi,> > > > > > > > > > On behalf of NetRUM I am honoured to extend> > > heart> > > > > felt thanks to Dr> > > > > Anupama Sucklecha for moderating the> > discussion> > > on> > > > > "Doping in sports "> > > > > from 01 to 07 April 2008.> > > > > > > > > > For the next E-discussion on NetRUM hearty> > > welcome> > > > > to Dr Bharat Gajjar> > > > > for moderating discussion on "Modern medicines> > > in> > > > > drinking water" which> > > > > will run from 09 April through 16 April 2008.> > > > > > > > > > Dr Bharat please take

over.> > > > > > > > > > Vijay> > > > > > > > > > Groupie> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> >> __________________________________________________________> > > _______________> > > > You rock. That's why Blockbuster's offering you> > > one month of > > > Blockbuster Total Access, No Cost. > > > >> > http://tc.deals./tc/blockbuster/text5.com> > > >> > > > > > > > > > > > > __________________________________________________> >

[Guest guest]

Dr Tariq, That is really a nice article and that too an Indian study. Another link I found useful: http://timesofindia.indiatimes.com/Drugs_found_in_drinking_water_/articleshow/2851988.cms -Anupama"M. Tariq Salman" <mtariqsalman@...> wrote: Dear all, I am attaching a research article entitled 'Effluent from drug manufactures contains extremely high levels of pharmaceuticals' which shows that there are high levels of Medicines, including antibiotics in water. The study was conducted in India.-- Dr. Mohd. Tariq Salman, MDSenior Resident,Department of Pharmacology,JN Medical College,Aligarh Muslim University,Aligarh, India. 202002http://mtariqsalman.googlepages.com/

Meet people who discuss and share your passions. Join them now.

[Guest guest]

Hello All,

Tariq"s and Anupama's attachments are real eye openers. I never thought that on one side

so much of medicine goes down the waste water while on the other side, there are people who do not get necessary medicine .

We in one of our studies found that people tend to store medicines, which they do not consume because of incomplete course, or for later use, or given by doctors as free sample.

these medicines are then overlooked till their expiry date which later find their way in the drain.

But what is important is the fact that the alaming levels of such medicines in drinking water is something we should seriously think about. These articles should wake us from our false myth that treated water ( that we get in our taps) is fit for drinking.

God help those who have to use untreated ground water.

kunda

-- On Fri, 11/4/08, M. Tariq Salman <mtariqsalman@...> wrote:

From: M. Tariq Salman <mtariqsalman@...>Subject: Re: Modern Medicines in Drinking Waternetrum Date: Friday, 11 April, 2008, 11:24 AM

Dear all,

I am attaching a research article entitled 'Effluent from drug manufactures contains extremely high levels of pharmaceuticals' which shows that there are high levels of Medicines, including antibiotics in water. The study was conducted in India.-- Dr. Mohd. Tariq Salman, MDSenior Resident,Department of Pharmacology,JN Medical College,Aligarh Muslim University,Aligarh, India. 202002http://mtariqsalman .googlepages. com/

Bring your gang together. Do your thing. Find your favourite Group.

[Guest guest]

I agree this article was really an eye opener although I would call it a Swedish study conducted in India (not an Indian study).

The worst effect is that on antibiotic resistance. To think we go through such pains to prevent this epidemic of antibiotic resistance by rationing antibiotics with all imaginable clinical skills to our patients (for example ciprofloxacin for typhoid) and yet the bacteria still ends up getting it through other channels!

With permission from the moderator I guess we should now discuss about alternative avenues of disposing these drugs and why we don't apply them.

rakesh

On 4/11/08, kunda gharpure <gharpurekunda@...> wrote:

Hello All,

Tariq " s and Anupama's attachments are real eye openers. I never thought that on one side

so much of medicine goes down the waste water while on the other side, there are people who do not get necessary medicine .

We in one of our studies found that people tend to store medicines, which they do not consume because of incomplete course, or for later use, or given by doctors as free sample.

these medicines are then overlooked till their expiry date which later find their way in the drain.

But what is important is the fact that the alaming levels of such medicines in drinking water is something we should seriously think about. These articles should wake us from our false myth that treated water ( that we get in our taps) is fit for drinking.

God help those who have to use untreated ground water.

kunda

-- On Fri, 11/4/08, M. Tariq Salman <mtariqsalman@...> wrote:

From: M. Tariq Salman <mtariqsalman@...>

Subject: Re: Modern Medicines in Drinking Waternetrum Date: Friday, 11 April, 2008, 11:24 AM

Dear all,

I am attaching a research article entitled 'Effluent from drug manufactures contains extremely high levels of pharmaceuticals' which shows that there are high levels of Medicines, including antibiotics in water. The study was conducted in India.

-- Dr. Mohd. Tariq Salman, MDSenior Resident,Department of Pharmacology,JN Medical College,Aligarh Muslim University,Aligarh, India. 202002http://mtariqsalman .googlepages. com/

Bring your gang together. Do your thing. Find your favourite Group.

[Guest guest]

Hello Sir,

Here is some information answering your questions.

During the past decade, there has been growing concern about potentially adverse effects of pharmaceuticals released in the environment through treated wastewater. These include prescription drugs such as hormones, antidepressants and antibiotics; over-the-counter medicines such as pain relievers, cold/flu remedies and antiseptics; and veterinary medicines. Small concentrations of these substances are found in various waterways nationwide.

Because of the large number of pharmaceuticals and the high cost of testing, relatively little data is available on the presence of pharmaceutical products in natural water bodies. U.S. Geological Survey (USGS) in 1999 and 2000 showed 80 percent of the samples were contaminated with one or more pharmaceuticals albeit at very low concentrations. Examples of medications found included acetaminophen, steroids, hormones, codeine, antibiotics, antimicrobials and ibuprofen.

Pharmaceuticals primarily enter wastewater treatment plants from two sources: 1) excretion by the human body; and 2) disposal of unused or expired medications down the toilet or drain. Hospitals and residences account for the majority of pharmaceuticals entering municipal wastewater treatment plants.

Two key points are to be shared: 1) unwanted medications should not be disposed down sinks, drains or toilets; and 2) unwanted or expired medications should be disposed of as hazardous waste. To implement this following steps are of help:

· Conduct or participate in regional trainings and provide follow-up with local hospitals and clinics regarding appropriate disposal

· Promote and support proper residential disposal practices for pharmaceuticals

· Include household hazardous waste drop-off events and take-back events at local senior centers and pharmacies

But then following guidelines seems contradictory.

Federal Guidelines: 2007

· Take unused, unneeded, or expired prescription drugs out of their original containers and throw them in the trash.

· Mixing prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and putting them in impermeable, non-descript containers, such as empty cans or sealable bags; will further ensure the drugs are not diverted.

· Flush prescription drugs down the toilet only if the label or accompanying patient information specifically instructs doing so.

· Take advantage of community pharmaceutical take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical take-back programs or community solid-waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, they are a good way to dispose of unused pharmaceuticals.

The FDA advises that the following drugs be flushed down the toilet instead of thrown in the trash:

Actiq (fentanyl citrate), Daytrana Transdermal Patch (methylphenidate), Duragesic Transdermal System (fentanyl), OxyContin Tablets (oxycodone), Avinza Capsules (morphine sulfate),Baraclude Tablets (entecavir), Reyataz Capsules (atazanavir sulfate), Tequin Tablets (gatifloxacin), Zerit for Oral Solution (stavudine), Meperidine HCl Tablets, Percocet (Oxycodone and Acetaminophen), Xyrem (Sodium Oxybate), Fentora (fentanyl buccal tablet)

Source URL

http://www.nodrugsdownthedrain.org/further.html

Regards,

Smita Mali

GMC, Nagpur.

>> Dear friends,> I think all the netrumians are in mini vacation mood.> Three holidays-in a row.Saturday, Sunday and Monday.> I repeat my questions.> Which are the drugs commonly and in significant amount> enter into water? What are the effects of these drugs> on aquatic and human life?> What precautions-consumers,pharmaceutical companies> and prescribers-should take to minimize the risk? > Bharat Gajjar,> Moderator.> > > __________________________________________________>

[Guest guest]

Dear Members:

I have just joined NETRUM and am still observing how it works. I find it quite informative and interesting, a pleasure indeed. Morever the current topic too is quite contemporary and thought-provoking. In this connection today itself I came across a news item in a local English Daily here whereunder it has been reported that expired drugs have been found dumped in large quantities on the banks of famous river Jhelum here in Habba Kadal locality. God only knows how many expired and unused drugs are dumped daily into water bodies across India. I wonder if there are any studies at all on the subject. The news item is attached herewith.

"Expired drugs dumped to kill - SMC, police clueless, people terrified" [Daily Greater Kashmir dt. April 14, 2008]ARSHAD ME’RAJ

Srinagar, Apr 13: In a brazen violation of the guidelines framed to destroy expired medicines, thousands of medicinal syrup bottles, capsule strips, injection vials and syringes have been dumped in Habba Kadal area. Locals say that some chemists dumped these here Saturday night. While the expired syrup bottles and other medicines scattered along roadside in this densely populated area has become a health threat, children can be seen playing in the dump for hours. Inhabitants of the area told Greater Kashmir that children take the medicines home, adding the piles of medicine was emitting pungent smell and pedestrian movement was made difficult. The drugs thrown on the roadside in large quantities include mit’s linctus codeine co, servit drops, seriworm, S-R Zyme, Panadom, vitamin-D tablets and besides others. “The expired medicines are being picked up by scores of rag pickers who bundle them in gunny bags and take them

away,†the residents told Greater Kashmir. They said the children residing in the vicinity have also taken hundreds of these medicines home and destroyed hundreds of such syrup bottles by throwing them against the wall. “Some of the children are seen tasting these medicines and many of them throw the bottles at each other while playing,†they further said. The medicine, the inhabitants said, was dumped last night by some druggists. Unaware as to who and how the druggists ferried such a large quantity of medicines to the area, the residents said that the dumping of medicine has become a nuisance for the residents. According to an official of the drug controller department, it is illegal to dump the expired medicine or any other drug in residential areas. “If a drug gets expired, it is imperative for the druggist to return it to the concerned company,†the official said. The official further said that if the drug has

to be destroyed, it has to be done in isolated place and the bottles have to emptied and subsequently broken to avoid any misuse. The official said that stringent action should be taken against the person involved in such an act and his license should be cancelled forthwith. When contacted, the deputy director drug control department, Nazir Ahmad Wani, said the department would inquire about the issue and would take action against the culprits. The concerned police station when contacted expressed ignorance over the issue saying that they would check it out.

Dr. Geer M. Ishaq

Sr. Lecturer

Dept. of Pharmaceutical Sciences

University of Kashmir

Srinagar-190006 (J & K)

Ph: 9419970971, 9906673100

E-mail: ishaq@...

Website: www.geocities.com/pharmsciences/ishaq.html

http://ishaqgeer.googlepages.com

Re: Modern Medicines in Drinking Water

Hello Sir,

Here is some information answering your questions.

During the past decade, there has been growing concern about potentially adverse effects of pharmaceuticals released in the environment through treated wastewater. These include prescription drugs such as hormones, antidepressants and antibiotics; over-the-counter medicines such as pain relievers, cold/flu remedies and antiseptics; and veterinary medicines. Small concentrations of these substances are found in various waterways nationwide.

Because of the large number of pharmaceuticals and the high cost of testing, relatively little data is available on the presence of pharmaceutical products in natural water bodies. U.S. Geological Survey (USGS) in 1999 and 2000 showed 80 percent of the samples were contaminated with one or more pharmaceuticals albeit at very low concentrations. Examples of medications found included acetaminophen, steroids, hormones, codeine, antibiotics, antimicrobials and ibuprofen.

Pharmaceuticals primarily enter wastewater treatment plants from two sources: 1) excretion by the human body; and 2) disposal of unused or expired medications down the toilet or drain. Hospitals and residences account for the majority of pharmaceuticals entering municipal wastewater treatment plants.

Two key points are to be shared: 1) unwanted medications should not be disposed down sinks, drains or toilets; and 2) unwanted or expired medications should be disposed of as hazardous waste. To implement this following steps are of help:

· Conduct or participate in regional trainings and provide follow-up with local hospitals and clinics regarding appropriate disposal

· Promote and support proper residential disposal practices for pharmaceuticals

· Include household hazardous waste drop-off events and take-back events at local senior centers and pharmacies

But then following guidelines seems contradictory.

Federal Guidelines: 2007

· Take unused, unneeded, or expired prescription drugs out of their original containers and throw them in the trash.

· Mixing prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and putting them in impermeable, non-descript containers, such as empty cans or sealable bags; will further ensure the drugs are not diverted.

· Flush prescription drugs down the toilet only if the label or accompanying patient information specifically instructs doing so.

· Take advantage of community pharmaceutical take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical take-back programs or community solid-waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, they are a good way to dispose of unused pharmaceuticals.

The FDA advises that the following drugs be flushed down the toilet instead of thrown in the trash:

Actiq (fentanyl citrate), Daytrana Transdermal Patch (methylphenidate) , Duragesic Transdermal System (fentanyl), OxyContin Tablets (oxycodone), Avinza Capsules (morphine sulfate),Baraclude Tablets (entecavir), Reyataz Capsules (atazanavir sulfate), Tequin Tablets (gatifloxacin) , Zerit for Oral Solution (stavudine), Meperidine HCl Tablets, Percocet (Oxycodone and Acetaminophen) , Xyrem (Sodium Oxybate), Fentora (fentanyl buccal tablet)

Source URL

http://www.nodrugsd ownthedrain. org/further. html

Regards,

Smita Mali

GMC, Nagpur.

>> Dear friends,> I think all the netrumians are in mini vacation mood.> Three holidays-in a row.Saturday, Sunday and Monday.> I repeat my questions.> Which are the drugs commonly and in significant amount> enter into water? What are the effects of these drugs> on aquatic and human life?> What precautions- consumers, pharmaceutical companies> and prescribers- should take to minimize the risk? > Bharat Gajjar,> Moderator.> > > ____________ _________ _________ _________ _________ __>

[Guest guest]

Yes it was useful information shared by Dr.Smita.It has been pointed

out that some medicines can be flushed down in the toilet,but in

country like India there doesnt seem any information about disposal

of medicines on the package.

Dr.Santosh Pillai

> >

> > Dear friends,

> > I think all the netrumians are in mini vacation mood.

> > Three holidays-in a row.Saturday, Sunday and Monday.

> > I repeat my questions.

> > Which are the drugs commonly and in significant amount

> > enter into water? What are the effects of these drugs

> > on aquatic and human life?

> > What precautions-consumers,pharmaceutical companies

> > and prescribers-should take to minimize the risk?

> > Bharat Gajjar,

> > Moderator.

> >

> >

> > __________________________________________________

> >

[Guest guest]

Dear friends, We have Useful Medicine banks. How about an idea of "Unused medicine stores-for safe disposal?" People can dump unused medicines and the responsibility of safe disposal will lie in their hands. That way many hazards due to medicines coming over in water, soil could be minimised. -Anupama"Dr. Smita Mali" <smt_mali@...> wrote: Hello Sir, Here is some information answering your questions. During the past decade, there has been growing concern about potentially adverse effects of pharmaceuticals released in the environment through treated wastewater. These include prescription drugs such as hormones, antidepressants and antibiotics; over-the-counter medicines such as pain relievers, cold/flu remedies and antiseptics; and veterinary medicines. Small concentrations of these substances are found in various waterways nationwide. Because of the large number of pharmaceuticals and the high cost of testing, relatively little data is available on the presence of pharmaceutical products in natural water bodies. U.S. Geological

Survey (USGS) in 1999 and 2000 showed 80 percent of the samples were contaminated with one or more pharmaceuticals albeit at very low concentrations. Examples of medications found included acetaminophen, steroids, hormones, codeine, antibiotics, antimicrobials and ibuprofen. Pharmaceuticals primarily enter wastewater treatment plants from two sources: 1) excretion by the human body; and 2) disposal of unused or expired medications down the toilet or drain. Hospitals and residences account for the majority of pharmaceuticals entering municipal wastewater treatment plants. Two key points are to be shared: 1) unwanted

medications should not be disposed down sinks, drains or toilets; and 2) unwanted or expired medications should be disposed of as hazardous waste. To implement this following steps are of help: · Conduct or participate in regional trainings and provide follow-up with local hospitals and clinics regarding appropriate disposal · Promote and

support proper residential disposal practices for pharmaceuticals · Include household hazardous waste drop-off events and take-back events at local senior centers and pharmacies But then following guidelines seems contradictory. Federal Guidelines:

2007 · Take unused, unneeded, or expired prescription drugs out of their original containers and throw them in the trash. · Mixing prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and putting them in impermeable, non-descript containers, such as empty cans or sealable bags; will further ensure

the drugs are not diverted. · Flush prescription drugs down the toilet only if the label or accompanying patient information specifically instructs doing so. · Take advantage of community pharmaceutical take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical take-back

programs or community solid-waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, they are a good way to dispose of unused pharmaceuticals. The FDA advises that the following drugs be flushed down the toilet instead of thrown in the trash: Actiq (fentanyl citrate), Daytrana Transdermal Patch (methylphenidate), Duragesic Transdermal System (fentanyl), OxyContin Tablets (oxycodone), Avinza Capsules (morphine sulfate),Baraclude Tablets (entecavir), Reyataz

Capsules (atazanavir sulfate), Tequin Tablets (gatifloxacin), Zerit for Oral Solution (stavudine), Meperidine HCl Tablets, Percocet (Oxycodone and Acetaminophen), Xyrem (Sodium Oxybate), Fentora (fentanyl buccal tablet) Source URL http://www.nodrugsdownthedrain.org/further.html Regards, Smita Mali GMC, Nagpur. >> Dear friends,> I think all the netrumians are in mini vacation mood.> Three holidays-in a row.Saturday, Sunday and Monday.> I repeat my questions.> Which are the drugs commonly and in significant amount> enter into water? What are the effects of these drugs> on aquatic and human life?> What precautions-consumers,pharmaceutical companies> and prescribers-should take to minimize the risk? > Bharat Gajjar,>

Moderator.> > > __________________________________________________>

[Guest guest]

Dear Dr. Ishaq,

Thank you for posting news item related to our topic.

It is eye-opening.

You all agree that we should think in this

direction.To generate awareness spark for this issue

was my motive behind putting this topic on discussion

board.I have succeded in my mission.

Once again thank you.

Dr.Bharat Gajjar.

Moderator.

--- ishaq geer <ishaqgeer@...> wrote:

> Dear Members:

> I have just joined NETRUM and am still observing how

> it works. I find it quite informative and

> interesting, a pleasure indeed. Morever the current

> topic too is quite contemporary and

> thought-provoking. In this connection today itself I

> came across a news item in a local English Daily

> here whereunder it has been reported that expired

> drugs have been found dumped in large quantities on

> the banks of famous river Jhelum here in Habba Kadal

> locality. God only knows how many expired and unused

> drugs are dumped daily into water bodies across

> India. I wonder if there are any studies at all on

> the subject. The news item is attached herewith.

>

> " Expired drugs dumped to kill - SMC, police

> clueless, people terrified " [Daily Greater Kashmir

> dt. April 14, 2008]

>

> ARSHAD ME’RAJ

>

>

>

> Srinagar, Apr 13: In a brazen violation of the

> guidelines framed to destroy expired medicines,

> thousands of medicinal syrup bottles, capsule

> strips, injection vials and syringes have been

> dumped in Habba Kadal area. Locals say that some

> chemists dumped these here Saturday night.

> While the expired syrup bottles and other medicines

> scattered along roadside in this densely populated

> area has become a health threat, children can be

> seen playing in the dump for hours. Inhabitants of

> the area told Greater Kashmir that children take the

> medicines home, adding the piles of medicine was

> emitting pungent smell and pedestrian movement was

> made difficult.

> The drugs thrown on the roadside in large

> quantities include mit’s linctus codeine co,

> servit drops, seriworm, S-R Zyme, Panadom, vitamin-D

> tablets and besides others..

> “The expired medicines are being picked up by

> scores of rag pickers who bundle them in gunny bags

> and take them away,†the residents told Greater

> Kashmir. They said the children residing in the

> vicinity have also taken hundreds of these medicines

> home and destroyed hundreds of such syrup bottles by

> throwing them against the wall. “Some of the

> children are seen tasting these medicines and many

> of them throw the bottles at each other while

> playing,†they further said.

> The medicine, the inhabitants said, was dumped last

> night by some druggists.

> Unaware as to who and how the druggists ferried

> such a large quantity of medicines to the area, the

> residents said that the dumping of medicine has

> become a nuisance for the residents.

> According to an official of the drug controller

> department, it is illegal to dump the expired

> medicine or any other drug in residential areas.

> “If a drug gets expired, it is imperative for the

> druggist to return it to the concerned company,â€

> the official said. The official further said that if

> the drug has to be destroyed, it has to be done in

> isolated place and the bottles have to emptied and

> subsequently broken to avoid any misuse. The

> official said that stringent action should be taken

> against the person involved in such an act and his

> license should be cancelled forthwith.

> When contacted, the deputy director drug control

> department, Nazir Ahmad Wani, said the department

> would inquire about the issue and would take action

> against the culprits. The concerned police station

> when contacted expressed ignorance over the issue

> saying that they would check it out.

>

>

>

> Dr. Geer M. Ishaq

> Sr. Lecturer

> Dept. of Pharmaceutical Sciences

> University of Kashmir

> Srinagar-190006 (J & K)

> Ph: 9419970971, 9906673100

> E-mail: ishaq@...

> Website: www.geocities.com/pharmsciences/ishaq.html

> http://ishaqgeer.googlepages.com

>

>

>

> Re: Modern Medicines in Drinking

> Water

>

> Hello Sir,

> Here is some information answering your questions.

> During the past decade, there has been growing

> concern about potentially adverse effects of

> pharmaceuticals released in the environment through

> treated wastewater. These include prescription drugs

> such as hormones, antidepressants and antibiotics;

> over-the-counter medicines such as pain relievers,

> cold/flu remedies and antiseptics; and veterinary

> medicines. Small concentrations of these substances

> are found in various waterways nationwide.

>

> Because of the large number of pharmaceuticals and

> the high cost of testing, relatively little data is

> available on the presence of pharmaceutical products

> in natural water bodies. U.S. Geological Survey

> (USGS) in 1999 and 2000 showed 80 percent of the

> samples were contaminated with one or more

> pharmaceuticals albeit at very low concentrations.

> Examples of medications found included

> acetaminophen, steroids, hormones, codeine,

> antibiotics, antimicrobials and ibuprofen.

>

> Pharmaceuticals primarily enter wastewater treatment

> plants from two sources: 1) excretion by the human

> body; and 2) disposal of unused or expired

> medications down the toilet or drain. Hospitals and

> residences account for the majority of

> pharmaceuticals entering municipal wastewater

> treatment plants.

>

> Two key points are to be shared: 1) unwanted

> medications should not be disposed down sinks,

> drains or toilets; and 2) unwanted or expired

> medications should be disposed of as hazardous

> waste. To implement this following steps are of

> help:

>

> · Conduct or participate in regional

> trainings and provide follow-up with local hospitals

> and clinics regarding appropriate disposal

> · Promote and support proper residential

> disposal practices for pharmaceuticals

> · Include household hazardous waste

> drop-off events and take-back events at local senior

> centers and pharmacies

>

> But then following guidelines seems contradictory.

> Federal Guidelines: 2007

> · Take unused, unneeded, or expired

> prescription drugs out of their original containers

> and throw them in the trash.

> · Mixing prescription drugs with an

> undesirable substance, such as used coffee grounds

> or kitty litter, and putting them in impermeable,

> non-descript containers, such as empty cans or

> sealable bags; will further ensure the drugs are not

> diverted.

> · Flush prescription drugs down the toilet

> only if the label or accompanying patient

> information specifically instructs doing so.

> · Take advantage of community

> pharmaceutical take-back programs that allow the

> public to bring unused drugs to a central location

> for proper disposal. Some communities have

> pharmaceutical take-back programs or community

> solid-waste programs that allow the public to bring

> unused drugs to a central location for proper

> disposal. Where these exist, they are a good way to

> dispose of unused pharmaceuticals.

> The FDA advises that the following drugs be flushed

> down the toilet instead of thrown in the trash:

>

> Actiq (fentanyl citrate), Daytrana Transdermal Patch

> (methylphenidate) , Duragesic Transdermal System

> (fentanyl), OxyContin Tablets (oxycodone), Avinza

> Capsules (morphine sulfate),Baraclude Tablets

> (entecavir), Reyataz Capsules (atazanavir sulfate),

> Tequin Tablets (gatifloxacin) , Zerit for Oral

> Solution (stavudine), Meperidine HCl Tablets,

> Percocet (Oxycodone and Acetaminophen) , Xyrem

> (Sodium Oxybate), Fentora (fentanyl buccal tablet)

>

> Source URL

> http://www.nodrugsd ownthedrain. org/further. html

>

> Regards,

> Smita Mali

> GMC, Nagpur.

>

>

> >

> > Dear friends,

> > I think all the netrumians are in mini vacation

> mood.

> > Three holidays-in a row.Saturday, Sunday and

> Monday.

> > I repeat my questions.

> > Which are the drugs commonly and in significant

> amount

> > enter into water? What are the effects of these

> drugs

> > on aquatic and human life?

>

=== message truncated ===

________________________________________________________________________________\

____

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know-it-all with Mobile. Try it now.

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[Guest guest]

Dear friends,

Dr.Smita has answered most of the questions.

Acetaminophen(Paracetamol),Aspirin,Steroids,Statins

are commonest drugs which enter into water.

What are the effects of these drugs on aquatic and

human life?

Regarding unused drugs,there is a nice suggestion by

Anupama.Unused medicines should be donated to

'MEDICINE BANK', so that they may be utilised for poor

and needy patients.

What are other measures which may be carried out by

patients(consumers),Prescribers and Pharmaceutical

Companies to minimise burden of unused medicines?

Dr. Bharat Gajjar.

Moderator.

--- " Dr. Smita Mali " <smt_mali@...> wrote:

>

> Hello Sir,

>

> Here is some information answering your questions.

>

> During the past decade, there has been growing

> concern about potentially

> adverse effects of pharmaceuticals released in the

> environment through

> treated wastewater. These include prescription drugs

> such as hormones,

> antidepressants and antibiotics; over-the-counter

> medicines such as pain

> relievers, cold/flu remedies and antiseptics; and

> veterinary medicines.

> Small concentrations of these substances are found

> in various waterways

> nationwide.

>

>

>

> Because of the large number of pharmaceuticals and

> the high cost of

> testing, relatively little data is available on the

> presence of

> pharmaceutical products in natural water bodies.

> U.S. Geological Survey

> (USGS) in 1999 and 2000 showed 80 percent of the

> samples were

> contaminated with one or more pharmaceuticals albeit

> at very low

> concentrations. Examples of medications found

> included acetaminophen,

> steroids, hormones, codeine, antibiotics,

> antimicrobials and ibuprofen.

>

>

>

> Pharmaceuticals primarily enter wastewater treatment

> plants from two

> sources: 1) excretion by the human body; and 2)

> disposal of unused or

> expired medications down the toilet or drain.

> Hospitals and residences

> account for the majority of pharmaceuticals entering

> municipal

> wastewater treatment plants.

>

>

>

> Two key points are to be shared: 1) unwanted

> medications should not be

> disposed down sinks, drains or toilets; and 2)

> unwanted or expired

> medications should be disposed of as hazardous

> waste. To implement this

> following steps are of help:

>

>

>

> · Conduct or participate in regional

> trainings and provide

> follow-up with local hospitals and clinics regarding

> appropriate

> disposal

>

> · Promote and support proper residential

> disposal practices

> for pharmaceuticals

>

> · Include household hazardous waste drop-off

> events and

> take-back events at local senior centers and

> pharmacies

>

>

>

> But then following guidelines seems contradictory.

>

> Federal Guidelines: 2007

>

> · Take unused, unneeded, or expired

> prescription drugs out of

> their original containers and throw them in the

> trash.

>

> · Mixing prescription drugs with an

> undesirable substance,

> such as used coffee grounds or kitty litter, and

> putting them in

> impermeable, non-descript containers, such as empty

> cans or sealable

> bags; will further ensure the drugs are not

> diverted.

>

> · Flush prescription drugs down the toilet

> only if the label

> or accompanying patient information specifically

> instructs doing so.

>

> · Take advantage of community pharmaceutical

> take-back

> programs that allow the public to bring unused drugs

> to a central

> location for proper disposal. Some communities have

> pharmaceutical

> take-back programs or community solid-waste programs

> that allow the

> public to bring unused drugs to a central location

> for proper disposal.

> Where these exist, they are a good way to dispose of

> unused

> pharmaceuticals.

>

> The FDA advises that the following drugs be flushed

> down the toilet

> instead of thrown in the trash:

>

>

>

> Actiq (fentanyl citrate), Daytrana Transdermal Patch

> (methylphenidate),

> Duragesic Transdermal System (fentanyl), OxyContin

> Tablets (oxycodone),

> Avinza Capsules (morphine sulfate),Baraclude Tablets

> (entecavir),

> Reyataz Capsules (atazanavir sulfate), Tequin

> Tablets (gatifloxacin),

> Zerit for Oral Solution (stavudine), Meperidine HCl

> Tablets, Percocet

> (Oxycodone and Acetaminophen), Xyrem (Sodium

> Oxybate), Fentora (fentanyl

> buccal tablet)

>

>

>

> Source URL

>

> http://www.nodrugsdownthedrain.org/further.html

> <http://www.nodrugsdownthedrain.org/further.html>

>

>

>

> Regards,

>

> Smita Mali

>

> GMC, Nagpur.

>

>

>

> >

> > Dear friends,

> > I think all the netrumians are in mini vacation

> mood.

> > Three holidays-in a row.Saturday, Sunday and

> Monday.

> > I repeat my questions.

> > Which are the drugs commonly and in significant

> amount

> > enter into water? What are the effects of these

> drugs

> > on aquatic and human life?

> > What precautions-consumers,pharmaceutical

> companies

> > and prescribers-should take to minimize the risk?

> > Bharat Gajjar,

> > Moderator.

> >

> >

> > __________________________________________________

> >

[Guest guest]

Hi,

In BMW management " polluter pays principle " is followed. This means

those who generate the waste must pay for its management. For eg.

private nursing homes must pay municipal /BMW managing company for

handling the BMW generated by individual facilities. This is in

practice in my city.

For medicine waste it should be " producer pays principle " which

means that pharmaceutical companies must take back the expired

medicines and ensure safe and scientific disposal. The pharma

companies can not just make the profits and get away. It is their

responsbility to keep the world clean of the toxic effects of their

produce.

Vijay Thawani

-- In netrum , Bharat Gajjar <gajjarbm@...> wrote:

>

> Dear friends,

> Dr.Smita has answered most of the questions.

> Acetaminophen(Paracetamol),Aspirin,Steroids,Statins

> are commonest drugs which enter into water.

> What are the effects of these drugs on aquatic and

> human life?

> Regarding unused drugs,there is a nice suggestion by

> Anupama.Unused medicines should be donated to

> 'MEDICINE BANK', so that they may be utilised for poor

> and needy patients.

> What are other measures which may be carried out by

> patients(consumers),Prescribers and Pharmaceutical

> Companies to minimise burden of unused medicines?

> Dr. Bharat Gajjar.

> Moderator.

>

> --- " Dr. Smita Mali " <smt_mali@...> wrote:

>

> >

> > Hello Sir,

> >

> > Here is some information answering your questions.

> >

> > During the past decade, there has been growing

> > concern about potentially

> > adverse effects of pharmaceuticals released in the

> > environment through

> > treated wastewater. These include prescription drugs

> > such as hormones,

> > antidepressants and antibiotics; over-the-counter

> > medicines such as pain

> > relievers, cold/flu remedies and antiseptics; and

> > veterinary medicines.

> > Small concentrations of these substances are found

> > in various waterways

> > nationwide.

> >

> >

> >

> > Because of the large number of pharmaceuticals and

> > the high cost of

> > testing, relatively little data is available on the

> > presence of

> > pharmaceutical products in natural water bodies.

> > U.S. Geological Survey

> > (USGS) in 1999 and 2000 showed 80 percent of the

> > samples were

> > contaminated with one or more pharmaceuticals albeit

> > at very low

> > concentrations. Examples of medications found

> > included acetaminophen,

> > steroids, hormones, codeine, antibiotics,

> > antimicrobials and ibuprofen.

> >

> >

> >

> > Pharmaceuticals primarily enter wastewater treatment

> > plants from two

> > sources: 1) excretion by the human body; and 2)

> > disposal of unused or

> > expired medications down the toilet or drain.

> > Hospitals and residences

> > account for the majority of pharmaceuticals entering

> > municipal

> > wastewater treatment plants.

> >

> >

> >

> > Two key points are to be shared: 1) unwanted

> > medications should not be

> > disposed down sinks, drains or toilets; and 2)

> > unwanted or expired

> > medications should be disposed of as hazardous

> > waste. To implement this

> > following steps are of help:

> >

> >

> >

> > · Conduct or participate in regional

> > trainings and provide

> > follow-up with local hospitals and clinics regarding

> > appropriate

> > disposal

> >

> > · Promote and support proper residential

> > disposal practices

> > for pharmaceuticals

> >

> > · Include household hazardous waste drop-off

> > events and

> > take-back events at local senior centers and

> > pharmacies

> >

> >

> >

> > But then following guidelines seems contradictory.

> >

> > Federal Guidelines: 2007

> >

> > · Take unused, unneeded, or expired

> > prescription drugs out of

> > their original containers and throw them in the

> > trash.

> >

> > · Mixing prescription drugs with an

> > undesirable substance,

> > such as used coffee grounds or kitty litter, and

> > putting them in

> > impermeable, non-descript containers, such as empty

> > cans or sealable

> > bags; will further ensure the drugs are not

> > diverted.

> >

> > · Flush prescription drugs down the toilet

> > only if the label

> > or accompanying patient information specifically

> > instructs doing so.

> >

> > · Take advantage of community pharmaceutical

> > take-back

> > programs that allow the public to bring unused drugs

> > to a central

> > location for proper disposal. Some communities have

> > pharmaceutical

> > take-back programs or community solid-waste programs

> > that allow the

> > public to bring unused drugs to a central location

> > for proper disposal.

> > Where these exist, they are a good way to dispose of

> > unused

> > pharmaceuticals.

> >

> > The FDA advises that the following drugs be flushed

> > down the toilet

> > instead of thrown in the trash:

> >

> >

> >

> > Actiq (fentanyl citrate), Daytrana Transdermal Patch

> > (methylphenidate),

> > Duragesic Transdermal System (fentanyl), OxyContin

> > Tablets (oxycodone),

> > Avinza Capsules (morphine sulfate),Baraclude Tablets

> > (entecavir),

> > Reyataz Capsules (atazanavir sulfate), Tequin

> > Tablets (gatifloxacin),

> > Zerit for Oral Solution (stavudine), Meperidine HCl

> > Tablets, Percocet

> > (Oxycodone and Acetaminophen), Xyrem (Sodium

> > Oxybate), Fentora (fentanyl

> > buccal tablet)

> >

> >

> >

> > Source URL

> >

> > http://www.nodrugsdownthedrain.org/further.html

> > <http://www.nodrugsdownthedrain.org/further.html>

> >

> >

> >

> > Regards,

> >

> > Smita Mali

> >

> > GMC, Nagpur.

> >

> >

> >

> > >

> > > Dear friends,

> > > I think all the netrumians are in mini vacation

> > mood.

> > > Three holidays-in a row.Saturday, Sunday and

> > Monday.

> > > I repeat my questions.

> > > Which are the drugs commonly and in significant

> > amount

> > > enter into water? What are the effects of these

> > drugs

> > > on aquatic and human life?

> > > What precautions-consumers,pharmaceutical

> > companies

> > > and prescribers-should take to minimize the risk?

> > > Bharat Gajjar,

> > > Moderator.

> > >

> > >

> > > __________________________________________________

> > >

[Guest guest]

Dear Members:

Tomorrow is the last day of this very interesting topic of discussion. To sum up some of the aspects relating to safe disposal of pharmaceuticals that have been left untouched so far, I am attaching herewith two important documents. First one is the WHO report on "Guidelines for safe disposal of unwanted pharmaceuticals" published by WHO Geneva in March 1999. The document comprehensively deals with almost all aspects on safe disposal of pharmaceuticals including various recommended disposal methods, consequences of improper disposal, sorting categories, expired or unwanted pharmaceuticals, disposal of solids, semi-solids, powders, liquids, ampoules, anti-infectives, controlled substances, anti-neoplastics, disinfectants, aerosol canisters etc. Another documents pertains to Ministry of Health and Family Welfare, Govt. of India that mainly includes a a desk review of the existing policy frameworks for environmental

protection and occupational safety and health in food and drug laboratories and covers topics like review of national legal and regulatory frameworks, environmental impacts, environmental impact management and mitigation etc. Hope these documents will shed some light on the issues under discussion.

In India provisions relating to import, manufacture, distribution and sale of drugs and cosmetics are regulated through Drugs and Cosmetics Act, 1940 and Rules thereunder. This Act has not undergone any major ammendment since 1985, though minor ammendments have taken place from time to time. Rule 58-A of the Drugs and Cosmetics Rules, 1945 outlines procedure for disposal of confiscated drugs and Rule 66-A briefly states the procedure for disposal of drugs in the event of cancellation of licence, however in both these rules details of how to actually destroy/dispose the pharmaceuticals is not mentioned. Rule 58-A just mentions that the destruction shall take place under the supervision of the Inspector in the presence of such authority, if any, as may be specified by the court and Rule 66-A mentions that the licensing authority may grant the necessary permission for their disposal. Nowhere it is mentioned

how to actually dispose the drugs. For expired drugs, Rule 65 (17) makes a provision for their withdrawal, reimbursement or disposal, as the case may be, subject to the condition that the same shall be stored separately from the trade stocks and all such drugs shall be kept in packages or cartons, the top of which shall display prominently, the words, "Not for Sale". Again there is no mention of how to actually carry out their disposal. Drugs and Cosmetics Act badly needs to be ammended to cover this issue.

Dr. Geer M. Ishaq

Sr. Lecturer

Dept. of Pharmaceutical Sciences

University of Kashmir

Srinagar-190006 (J & K)

Ph: 9419970971, 9906673100

E-mail: ishaq@...

Website: www.geocities.com/pharmsciences/ishaq.html

http://ishaqgeer.googlepages.com

Modern Medicines in Drinking Water

Dear Geer,Thanks for the eye opener from Kashmir. The shopkeepers are known to discard the expired medicines in municipal garbage dumps. The statement of the "official" in the news story attached by you reads : "The official further said that if the drug has to be destroyed, it has to be done in isolated place and the bottles have to emptied and subsequently broken to avoid any misuse ".I leave it to the moderator to comment on this.Vijay ThawaniGroupie > >> > Dear friends,> > I think all the netrumians are in mini vacation mood.> > Three holidays-in a row.Saturday, Sunday and Monday.> > I repeat my questions.> > Which are the drugs commonly and in significant amount> > enter into water? What are the effects of these drugs> > on aquatic and human life?> > What precautions- consumers, pharmaceutical companies> > and prescribers- should take to minimize the risk?

> > Bharat Gajjar,> > Moderator.> > > > > > ____________ _________ _________ _________ _________ __> >

[Guest guest]

The Drug Disposal Group www.mainebenzo.org both encourages endorsement of

the Athens Declaration on this topic, and would suggest that the

environment might be better defined as not excluding huimans. Hence the

effect of unused pharmaceuticals in the environment would include,

1) childhood poisoning from unintended ingestion

2) pharmaceutical abuse secondary to household theft

3) mistaken dosing form confusion among elderly who may accumulate many

drugs over their lifetime

4) the ecological effect on wildlife

5) the effect of improper international drug donations not meeting WHO

guidelines following natural diusaster or war.

6) the effect upon an economy of the waste dollars for the drugs that are

unused

Stevan Gressitt, M.D.

www.mainebenzo.org

> Dear friends,

> How do drugs affect our environment?

> Varying concentrations of drugs have been found in

> nearly every water source in the U.S. and Canada. The

> EPA has compiled a growing body of evidence

> demonstrating how Pharmaceuticals and Personal Care

> Products (PPCPs) affect aquatic life. Findings

> include: estrogens cause male fish to become female;

> antidepressants cause lobsters to be more aggressive;

> Prozac induces reproduction in shellfish.

>

> How does this affect human health?

> The evidence for the direct consequences of PPCPs on

> humans is only beginning to be investigated. A

> landmark study in 2006 found that a mix of 13 common

> medications common to drinking water inhibits cell

> growth in human embryonic cells. This is one of the

> few studies that looks looks at how mixtures of

> prevalent medications can affect biological activity

> even at low concentrations. The affects on aquatic

> life suggest we should take precaution and prevent

> pharmaceutical pollution from further damaging our

> environment.

> Dr. Bharat Gajjar,

> Moderator.

>

>

>

>

>

________________________________________________________________________________\

____

> Be a better friend, newshound, and

> know-it-all with Mobile. Try it now.

> http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ

>

--

Stevan Gressitt, M.D.

207-441-0291

www.mainebenzo.org

[Guest guest]

However uin some countries it is the policies of the payors, i.e.,

governments or insurance companies that might set perverse incentives for

excessive dispensing. Or selection of formulary choices that may have

higher side-effect and hence lower adherence rates.

Hence the shift from polluter pays ( the consumer who does not use the

drug) to producer pays ( hmm the manufacturer in a 3rd country? ) I'm not

so sure...

Stevan Gressitt, M.D.

www.mainebenzo.org

> Hi,

>

> In BMW management " polluter pays principle " is followed. This means

> those who generate the waste must pay for its management. For eg.

> private nursing homes must pay municipal /BMW managing company for

> handling the BMW generated by individual facilities. This is in

> practice in my city.

>

> For medicine waste it should be " producer pays principle " which

> means that pharmaceutical companies must take back the expired

> medicines and ensure safe and scientific disposal. The pharma

> companies can not just make the profits and get away. It is their

> responsbility to keep the world clean of the toxic effects of their

> produce.

>

> Vijay Thawani

>

>

>

> -- In netrum , Bharat Gajjar <gajjarbm@...> wrote:

>>

>> Dear friends,

>> Dr.Smita has answered most of the questions.

>> Acetaminophen(Paracetamol),Aspirin,Steroids,Statins

>> are commonest drugs which enter into water.

>> What are the effects of these drugs on aquatic and

>> human life?

>> Regarding unused drugs,there is a nice suggestion by

>> Anupama.Unused medicines should be donated to

>> 'MEDICINE BANK', so that they may be utilised for poor

>> and needy patients.

>> What are other measures which may be carried out by

>> patients(consumers),Prescribers and Pharmaceutical

>> Companies to minimise burden of unused medicines?

>> Dr. Bharat Gajjar.

>> Moderator.

>>

>> --- " Dr. Smita Mali " <smt_mali@...> wrote:

>>

>> >

>> > Hello Sir,

>> >

>> > Here is some information answering your questions.

>> >

>> > During the past decade, there has been growing

>> > concern about potentially

>> > adverse effects of pharmaceuticals released in the

>> > environment through

>> > treated wastewater. These include prescription drugs

>> > such as hormones,

>> > antidepressants and antibiotics; over-the-counter

>> > medicines such as pain

>> > relievers, cold/flu remedies and antiseptics; and

>> > veterinary medicines.

>> > Small concentrations of these substances are found

>> > in various waterways

>> > nationwide.

>> >

>> >

>> >

>> > Because of the large number of pharmaceuticals and

>> > the high cost of

>> > testing, relatively little data is available on the

>> > presence of

>> > pharmaceutical products in natural water bodies.

>> > U.S. Geological Survey

>> > (USGS) in 1999 and 2000 showed 80 percent of the

>> > samples were

>> > contaminated with one or more pharmaceuticals albeit

>> > at very low

>> > concentrations. Examples of medications found

>> > included acetaminophen,

>> > steroids, hormones, codeine, antibiotics,

>> > antimicrobials and ibuprofen.

>> >

>> >

>> >

>> > Pharmaceuticals primarily enter wastewater treatment

>> > plants from two

>> > sources: 1) excretion by the human body; and 2)

>> > disposal of unused or

>> > expired medications down the toilet or drain.

>> > Hospitals and residences

>> > account for the majority of pharmaceuticals entering

>> > municipal

>> > wastewater treatment plants.

>> >

>> >

>> >

>> > Two key points are to be shared: 1) unwanted

>> > medications should not be

>> > disposed down sinks, drains or toilets; and 2)

>> > unwanted or expired

>> > medications should be disposed of as hazardous

>> > waste. To implement this

>> > following steps are of help:

>> >

>> >

>> >

>> > · Conduct or participate in regional

>> > trainings and provide

>> > follow-up with local hospitals and clinics regarding

>> > appropriate

>> > disposal

>> >

>> > · Promote and support proper residential

>> > disposal practices

>> > for pharmaceuticals

>> >

>> > · Include household hazardous waste drop-off

>> > events and

>> > take-back events at local senior centers and

>> > pharmacies

>> >

>> >

>> >

>> > But then following guidelines seems contradictory.

>> >

>> > Federal Guidelines: 2007

>> >

>> > · Take unused, unneeded, or expired

>> > prescription drugs out of

>> > their original containers and throw them in the

>> > trash.

>> >

>> > · Mixing prescription drugs with an

>> > undesirable substance,

>> > such as used coffee grounds or kitty litter, and

>> > putting them in

>> > impermeable, non-descript containers, such as empty

>> > cans or sealable

>> > bags; will further ensure the drugs are not

>> > diverted.

>> >

>> > · Flush prescription drugs down the toilet

>> > only if the label

>> > or accompanying patient information specifically

>> > instructs doing so.

>> >

>> > · Take advantage of community pharmaceutical

>> > take-back

>> > programs that allow the public to bring unused drugs

>> > to a central

>> > location for proper disposal. Some communities have

>> > pharmaceutical

>> > take-back programs or community solid-waste programs

>> > that allow the

>> > public to bring unused drugs to a central location

>> > for proper disposal.

>> > Where these exist, they are a good way to dispose of

>> > unused

>> > pharmaceuticals.

>> >

>> > The FDA advises that the following drugs be flushed

>> > down the toilet

>> > instead of thrown in the trash:

>> >

>> >

>> >

>> > Actiq (fentanyl citrate), Daytrana Transdermal Patch

>> > (methylphenidate),

>> > Duragesic Transdermal System (fentanyl), OxyContin

>> > Tablets (oxycodone),

>> > Avinza Capsules (morphine sulfate),Baraclude Tablets

>> > (entecavir),

>> > Reyataz Capsules (atazanavir sulfate), Tequin

>> > Tablets (gatifloxacin),

>> > Zerit for Oral Solution (stavudine), Meperidine HCl

>> > Tablets, Percocet

>> > (Oxycodone and Acetaminophen), Xyrem (Sodium

>> > Oxybate), Fentora (fentanyl

>> > buccal tablet)

>> >

>> >

>> >

>> > Source URL

>> >

>> > http://www.nodrugsdownthedrain.org/further.html

>> > <http://www.nodrugsdownthedrain.org/further.html>

>> >

>> >

>> >

>> > Regards,

>> >

>> > Smita Mali

>> >

>> > GMC, Nagpur.

>> >

>> >

>> >

>> > >

>> > > Dear friends,

>> > > I think all the netrumians are in mini vacation

>> > mood.

>> > > Three holidays-in a row.Saturday, Sunday and

>> > Monday.

>> > > I repeat my questions.

>> > > Which are the drugs commonly and in significant

>> > amount

>> > > enter into water? What are the effects of these

>> > drugs

>> > > on aquatic and human life?

>> > > What precautions-consumers,pharmaceutical

>> > companies

>> > > and prescribers-should take to minimize the risk?

>> > > Bharat Gajjar,

>> > > Moderator.

>> > >

>> > >

>> > > __________________________________________________

>> > >