anaerobic conditions. However, several studies have found concentrations of environmental relevance in surface waters. Therefore, there is a need to investigate new
alternative post-treatment techniques for their removal from waste water.
As numerous studies have shown NSAIDs-induced harmful toxic effects on
nontargeted organisms, we conclude these drugs are a potential threat to the environment. However, further research is needed to better understand the neurotoxicity
and endocrine disruption effects of these pollutants. Furthermore, as these drugs
share similar mode of action is likely they coexist in the aquatic environments.
Therefore, it is of paramount importance to assess the effects of these drugs on a
complex mixture. Finally, future works must focus on only to investigate the toxic
effects produced at environmentally relevant concentrations.
References
1. Schrör K, Voelker M (2016) NSAIDS and aspirin: recent advances and implications for
clinical management. In: NSAIDs and aspirin. Springer, Cham, pp 107–122
2. Vane JR, Botting RM (1998) Anti-inflammatory drugs and their mechanism of action.
Inflamm Res 47(2):78–87
3. Saad J, Pellegrini MV (2019) Nonsteroidal anti-inflammatory drugs (NSAID) toxicity. In:
StatPearls [Internet]. StatPearls Publishing
4. Brun GL, Bernier M, Losier R, Doe K, Jackman P, Lee HB (2006) Pharmaceutically active
compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters, and
potential for environmental effects as measured by acute and chronic aquatic toxicity. Environ
Toxicol Chem Int J 25(8):2163–2176
5. Selke S, Scheurell M, Shah MR, Hühnerfuss H (2010) Identification and enantioselective gas
chromatographic mass-spectrometric separation of O-desmethylnaproxen, the main metabolite
of the drug naproxen, as a new environmental contaminant. J Chromatogr A 1217(3):419–423
6. Islas-Flores H, Gómez-Oliván LM, Galar-Martínez M, García-Medina S, Neri-Cruz N,
Dublán-García O (2014) Effect of ibuprofen exposure on blood, gill, liver, and brain on
common carp (Cyprinus carpio) using oxidative stress biomarkers. Environ Sci Pollut Res
21(7):5157–5166
7. Mezzelani M, Gorbi S, Da Ros Z, Fattorini D, d’Errico G, Milan M et al (2016) Ecotoxicological potential of non-steroidal anti-inflammatory drugs (NSAIDs) in marine organisms:
bioavailability, biomarkers and natural occurrence in Mytilus galloprovincialis. Mar Environ
Res 121:31–39
8. Stancova V, Plhalova L, Blahova J, Zivna D, Bartoskova M, Siroka Z et al (2017) Effects of
the pharmaceutical contaminants ibuprofen, diclofenac, and carbamazepine alone, and in
combination, on oxidative stress parameters in early life stages of tench (Tinca tinca).
Veterinární Medicína 62(2):90–97
9. Medical Expenditure Panel Survey (MEPS) (2018) Agency for Healthcare Research and
Quality (AHRQ), Rockville, MD. ClinCalc DrugStats Database version 19.1. https://
clincalc.com/DrugStats/Top200Drugs.aspx
10. Prescribing and Medicines Team Health and Social Care Information Centre (2018) Prescriptions Dispensed in the Community - Statistics for England, 2007-2017. Health and Social
Care Information Centre, UK. https://digital.nhs.uk/data-and-information/publications/statisti
cal/prescriptions-dispensed-in-the-community/prescriptions-dispensed-in-the-communityengland%2D%2D-2007%2D%2D-2017
Introduction and Historical Findings That Focused Nonsteroidal. . .
33
alternative post-treatment techniques for their removal from waste water.
As numerous studies have shown NSAIDs-induced harmful toxic effects on
nontargeted organisms, we conclude these drugs are a potential threat to the environment. However, further research is needed to better understand the neurotoxicity
and endocrine disruption effects of these pollutants. Furthermore, as these drugs
share similar mode of action is likely they coexist in the aquatic environments.
Therefore, it is of paramount importance to assess the effects of these drugs on a
complex mixture. Finally, future works must focus on only to investigate the toxic
effects produced at environmentally relevant concentrations.
References
1. Schrör K, Voelker M (2016) NSAIDS and aspirin: recent advances and implications for
clinical management. In: NSAIDs and aspirin. Springer, Cham, pp 107–122
2. Vane JR, Botting RM (1998) Anti-inflammatory drugs and their mechanism of action.
Inflamm Res 47(2):78–87
3. Saad J, Pellegrini MV (2019) Nonsteroidal anti-inflammatory drugs (NSAID) toxicity. In:
StatPearls [Internet]. StatPearls Publishing
4. Brun GL, Bernier M, Losier R, Doe K, Jackman P, Lee HB (2006) Pharmaceutically active
compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters, and
potential for environmental effects as measured by acute and chronic aquatic toxicity. Environ
Toxicol Chem Int J 25(8):2163–2176
5. Selke S, Scheurell M, Shah MR, Hühnerfuss H (2010) Identification and enantioselective gas
chromatographic mass-spectrometric separation of O-desmethylnaproxen, the main metabolite
of the drug naproxen, as a new environmental contaminant. J Chromatogr A 1217(3):419–423
6. Islas-Flores H, Gómez-Oliván LM, Galar-Martínez M, García-Medina S, Neri-Cruz N,
Dublán-García O (2014) Effect of ibuprofen exposure on blood, gill, liver, and brain on
common carp (Cyprinus carpio) using oxidative stress biomarkers. Environ Sci Pollut Res
21(7):5157–5166
7. Mezzelani M, Gorbi S, Da Ros Z, Fattorini D, d’Errico G, Milan M et al (2016) Ecotoxicological potential of non-steroidal anti-inflammatory drugs (NSAIDs) in marine organisms:
bioavailability, biomarkers and natural occurrence in Mytilus galloprovincialis. Mar Environ
Res 121:31–39
8. Stancova V, Plhalova L, Blahova J, Zivna D, Bartoskova M, Siroka Z et al (2017) Effects of
the pharmaceutical contaminants ibuprofen, diclofenac, and carbamazepine alone, and in
combination, on oxidative stress parameters in early life stages of tench (Tinca tinca).
Veterinární Medicína 62(2):90–97
9. Medical Expenditure Panel Survey (MEPS) (2018) Agency for Healthcare Research and
Quality (AHRQ), Rockville, MD. ClinCalc DrugStats Database version 19.1. https://
clincalc.com/DrugStats/Top200Drugs.aspx
10. Prescribing and Medicines Team Health and Social Care Information Centre (2018) Prescriptions Dispensed in the Community - Statistics for England, 2007-2017. Health and Social
Care Information Centre, UK. https://digital.nhs.uk/data-and-information/publications/statisti
cal/prescriptions-dispensed-in-the-community/prescriptions-dispensed-in-the-communityengland%2D%2D-2007%2D%2D-2017
Introduction and Historical Findings That Focused Nonsteroidal. . .
33