1. INTRODUCTION:

The drug waste contain all the atoms that people no longer have any use for, which they either intended to get rid of or have already discarded, additionally waste are such atoms which people are required to discard. Drug waste is cause for the concern because it poses threat to human and environmental health, because of the dangers, drug waste can not be dispose like conventional waste, it requires a special handling whether it comes from the hospital, pharmacy, or private household.

There are several concern with the drug waste management. Some drugs contain heavy metals, endocrine disrupters, and to many another compounds that are dangerous for animals and environment too. These problems are mostly occurred in rivers-streams, that the normally prescribed doses and there is concern that chronic exposure to the numerous causes serious health problems and that can act synergistically to cause adverse health effects.

These problems disturb internal and biological processes such as development and growth and reproduction that are regulated by the hormones in both plants and animals. Medical authorized advice that consumer not store any drug that they not have the reason at present to process. storing the drug creates the possibility that someone will use them inappropriately and suffer harm, accentual ingestion of medications prescribed for another individual is leading source of poisining. Soil Varieties of the pharmaceuticals products are traced in the aquatic resources and soil such as analgesics, antibiotic and stimulants. According to the environmental protection authority victoria <21> a point source is a single identifiable source of pollution such as a pipe or drain. The industrial waste is commonly discarded to the river and the water resources which pollute the nearby soil or adjacent water bodies¹. Now a days a agriculture is a key source of a diffuse pollution, but the urban land, atmospheric deposition and rural dwelling and forestry can also be a important sources.

2. GENERAL METHODS FOR DRUG DISPOSAL:

The most obvious way for individual is through the household waste management service. These are throwing medicines in sinking and toilet and dustbins which are environment unfriendly. It leads to the environmental contamination. The pharmaceutical research and manufactures of America have evaluated unused medicines disposal options and concluded that the general disposal methods are avoided and allow take back program and effective to reduce their presence in environment.

According to the FDA guidelines, don not flush medicines down the sink or toilet unless this information specifically instruct to you do so.

1. Landfill- It means that the drugs are placed in to land disposal site without any prior treatments it is the oldest method for disposing of solid dosage for. A well-managed landfill can be inexpensive method of disposing of waste materials². It also divided into two types 1) open dump,2) engineered landfill

2. Open dump- Untreated drugs discarded in to a open dump, these method is suitable for the less toxic drugs because these may dose not lead to the less pollution of soil and environment.

3. Engineered landfill - It consist of the final site allow final disposal of solid waste in a secure manner by minimizing the impact on the environment³.

If above format is not useful to you then,

1. Remove these from their container and mix them with undesirable substances such as you can use coffee grounds and kitty little, this makes the drug less appealing to children and pets. Place the mixture in a sealed bag, empty can and other containers to prevent the drug from leaking and breaking out of the garbage bag.

2. Liquid medicines should be mix with salt flour charcoal and nontoxic powders spice such as turmeric or mustard to give the mixture and an unappealing smell and texture.

3. Medicines in blister packs should be wrapped in multiple layer of opaque tape and then place inside the containers such as empty can, dispose these containers in the trash. Lots of countries like UK, Columbia. Sweden, Australia implement. Drug Takr Back Programm.

4. Liquefaction or condensation -Liquefaction of gases is the process by which substances in their gaseous state are converted in to a liquid state. When the pressure on the gas is increased the molecules closure together and its temperature is reduced and they are converted in to liquid state.

3. METHODS:

1. Incineration- It is a method of treatment process that involve the combustion of waste substance contain in waste materials, these treatment are also known as the thermal treatment. Incineration of waste materials convert waste in to ash, flue gas and heat. These method contain clinical waste and certain hazardous wastes where pathogens and toxins are destroyed at high temp. These method is not useful in case of inhalers because it leads to combustion of gases. These is a paratical method of drug disposal⁴

2. Autoclave - The process dells with the sterilization and treatments of waste before it dumped as a garbage, it is the extremelyportant part of the waste management because the waste have hazardous effect on the environment, that may leads to contamination of landfill, water resources. Due to autoclaving the hazardous effects of the drug may be minimized. Autoclave operation requires qualified technique and medium investment.

3. Microwaving - Use of associate degree magnetic attraction field over the BMW incites the fluid inside the waste to waver and warmth up, obliterating the irresistible parts by conductivity. This technology needs medium investment and operational prices. Chemical medical aid, addition of sturdy oxidants like gas components, ammonium ion salt. These technology requires medium investment and operating cost.

4. Deep burial - A pitch or trench should be dug about 2m deep. It should be half filled with waste, and then covered with lime within 50 cm of the surface, before filling the rest of the pit with soil, it must be ensured that animals do not have access to b sites. Burial at present the corporation of the city panaji collect and treat it at the Goa medical collage and hospital at bambolim.

5. Secure landfilling - A secure landfilling a carefully engineered area that is used to define waste products. a hole in the landfill but it also may build in the ground, it requires 3 m separation between the bottom of the landfill and the underlying bedrock and groundwater table. A properly designed and well managed landfill can be hygienic and relatively inexpensive method of disposal ⁵.

6. Waste immobilization- It the process involving the conversion of waste into waste form by solidification, embedding, or encapsulation.

7. Reuse: In case of the unused unexpired drugs or dosage forms we can donate these medicines to the required ones, donation should benefit the recipients and meet the needs of the end users and recipients.

8. Recycling- The drug recycling is the idea that healthcare organization or consumers with unused drug can transfer them in a safe and appropriate way to another consumer who needs them. These would happens through a specialized pharmacy industries or medical organizations.

9. Bioremediation - It employs the use of living organisms, like microbes and bacteria, in the removal of contaminants, pollutants, and toxins from soil, water and air ⁶. This technique can be use for clearing pharmaceutical waste from environment. As pharmaceutical waste contains of chemicals and drugs such as hormone, anitibiotics, steroids, anti-inflammatory, antidepressant, analgesic, diuretics and many more drugs. Due to such type of waste it becomes difficult to clear it.

To avoid harmful effects these waste must be tread and should be converted into nontoxic material. Bioremediation is done under aerobic and anaerobic conditions.

Anaerobic microorganism capable of degrading steroid hormones from wastewate. Table 1 shows microorganism with its mechanism. Where : E1 estrone, E2 estradiol.

Table 1: Micro-organisum and their machanisum.

Sr No.	Class	Microorganim	Mechanism
1)	β-Proteobacteria	Denitratisoma oestradiolicumAcBE2-1T	Metabolism of E1, E2 under the denitrifying condition

4. FORMULATIONS AND DRUG DISPOSAL ACCOUDING TO VARIOUS DOSAGE FORMS:

1. Tablets Ans Capsules - According to the pollution control board of the state, up to 50 tablets and capsules sock in the 100ml water and collect same in the polythene bag containing tea coffee grind seal the bag and put it in trash. Eg. NSIDs- Ibuprefen, Dichlofenac, Paracetamol, Naproxen. Beta- blocker - Atenelol, soltalol, propranolol, metoprolol. Anti-dipressent- Fluxitin, Dizepam, preservative- Methylparaben. For large quantity - Drug crush in the heavy duty crusher, collect in the polythene bag and seal dispose in a high temperature at 850 to 1200⁰C.

2. Oral liquids and intravenous fluids - Small quantity liquids are diluted with water. Large quantity liquids - They are diluted with water in effluent treatment plants, it gives various materials depending on the type of industry such as oil and grease from automobile industry gives heavy metals and food and beverages gives degradable organic compounds. High semi solid liquids disposal off in an incinerator.

3. Injectable and ampoules and vials - Up to 50 ampoules and vials open by breaking container and collect liquid in polythene bag containing coffee and tea grind, seal the bag and dispose in trash. Large quantity - Use heavy crusher to separate the liquids and diluted with water in ETP of industry. Powder injections -Dispose off in incinerator.

4. Steroids- small quantity -50 tablets in 1N NaoH for 30 min and trash. large quantity -disposed of in incinerator.

5. Harmones -small quantity -Aqueous solution is to be exposed off to the UV. Small quantity of hormones in aqueous solution like estrogen, aspirin should be exposed to the ultra sound at 0.6 to 2KW in sonicator for 60 min and trash. Eg. Estriol, Estrone ⁷. Large quantity - Incinerator disposal.

6. Disinfectants - small quantity -Use it. Large quantity - More than 50 lit, etc dilute with quantity water to ensure dilution with loss of activity and drain it in ETP. Eg. Tetracycline

7. Semi-solid - small quantity - They are mix with the tea coffee grind in polythene bag, seal the bag and trash. Large quantity -They are incinerator in incinerator.

8. Anti-infective formulation -ex-Tetracycline -small quantity- they are sock in a 10% caOH solution foe 30 min and trash. Ex- Erythromycin and clarithromycin -small quantity - they are socked in 1N HCL acid, and trash.

9. Inhelar - One environmental concern involve the inhalers used by people who have asthma and other breathing problems such as various pulmonary diseases, these products are dangerous if punctured and thrown in to the fire or incinerator so proper disposal of these ones are very important. These products can disposed of by liquefaction process or by treated under the high pressure.

10. Lebel need for proper drug disposal - The drug disposal conditions have to maintain on the label for the awareness in the society of proper drug disposal.

The proper drug disposal leads reduction of environmental pollution. The hazardous drugs observe special handling, administration and disposal requirements. The various symbols can also use to determine the process of drug disposal. The disposal of hazardous drugs can mention in the red coloured strip. Figure 1 show's drug disposal practice according to type of the drug.

Figure 1: steps for drug disposal.

5. HOW TO MINIMIZE THE DRUG WASTE:

5.1. Take Back Programm:

The India is major country for manufacture of pharmaceuticals have need to implement these program. Medicine take back operation are the best way to safely dispose of most type of unneeded or expired prescription and over the counter medication. There are few select medicines with specific instruction, there are two kind of take back options. 1) permanent collection location and sites. 2) perodic event.

Before disposing of medicines use a drug take back program and be sure to remove all personal information on the label of pills bottles and medicines packaging.

Some facilities and business are also have to register with the enforcement administration to collect old, unused, unneeded or expired medicines, the authorized drug collection safely and surely gather and dispose of pharmaceuticals contain controlled substances as well other medicines this helps health care center as well as promote environmental health⁸.Receptacle given in figure 2 should be there to practice this program.

Figure2: Drug Disposal Box.

5.2. By Drug Donation:

The drug donation is the process in which the unused drugs are donated to the needed ones in case of drug donation some conditions have to follow like, usually the packaging must be unopened and sealed or the drugs must be packaged in individual dose (in sealed blister pack), be dinpence only by prescription and aproved by food and drug administration. The expired drugs and controlled substances are not allow for donation. In our government there is no scheme for recycling of the unused drugs therefore the drug donation is the best option to reduce the drug waste foe controlling environmental pollution. In case of the liquid dosage forms or aerosols the container should not be liked to donate.

6. RISK OF DRUG WASTE TO ENVIRONMENT:

Once pharmaceutical drug are released into environment drugs will distributed to air, water, soil or even sediment. Drug deposited in environment are degrade by microorganism but these degrade form of drug may also have toxic effect on living species surrounding them. Pharmaceutical drugs are designed to be highly lipophilic and hydrophilic which when disposed may get either dissolved in water system or adsorbed on lipid layer of living organism resulting impact on both living thing animals and microorganisms and non-living matters like water bodies, soil, air.

1. It has negative environmental impact:

2. It can laid to accidental poisoning:

1. Negative environmental impact — It is bad to flush medicines down the toilet because medicines flush down the toilet the drain can contaminate our water resources such as lakes and streams and so many. when medicines are flush down the toilet or drain they enter the waste water treatment system, which cleans up the water. Drug which when deposited into any part of nature by improper method leads to potential harm to human, animal, plants, marine ecosystem. These potent drug can may bring changes in species this changes includes behaviour ,mutation, reproduction, life span⁹.

A. Drug leaching into water systems:

Many pharma industry deposit there chemical waste in water which laid to leaching of water and disturbance of marine ecosystem, drinking water spoilage. This leached water which when consumed by any species brings genetic modification or gene mutation. Approximately 170,000 public water systems are monitored for nearly 80 harmful substances. chemical contaminants in tap and drinking water, initiate the evolution of contagious diseases¹⁰.

This may laid diseases like physical, mental, behaviour retardation. This contamination of water may give rise to new diseases in living species dependent on water.

a. Marine:

Drug pollution is nowadays detected in water throughout the world said a scientist at cary institute of ecosystem studies. The fish in the potomic river may look normal at first glance but many of the Potomasc male bass are producing eggs at the mid-atlantic region of the United states¹¹.

This huge transformation is due to mutation The environmental impact studies investigate the potential negative effect on fish, daphnids, algae, bacteria, earthworm, plants and dung invertebrates.

B. Drugs effect on soil:

Disposal of solid, semisolid, liquid drug into soil laid to adulteration of soil with harmful chemicals which then transmit into plants casing genetic changes in plants. Contamination of soil due to drug laid to the decrease in fertility of soil. It is highly toxic to plants and it making it unfit for vegetation thus making it mildly poisonous.

C. Drugs effect on air:

One environmental concern involves inhalers used by athematic patients, other breathing problems or pulmonary diseases this product could be dangerous if punctured or thrown into a fire. Inhalation of volatile drug may lead to psychoactive effects. Some drugs are volatile during process of decomposition. These volatile drug may show effects on organism by inhalation through skin contact, respiration, deposition in eyes. Low molecular weight chemicals (molecular weight <500 Da) that have good solubility in both water and fat penetrate the skin more readily¹². Therefore the proper disposal of this products is followed by local regulation and recycling facilities.

6.1. List of Drugs Causing Imact on Environment

1. Effect of antidepressant drug:

Antidepressant drug treat depression disorder, anxiety, chronicc pain. The major antidepressant drug used is fluoxentine (Prazac). In research it was found that female starlings fed food spiked with the antidepressant fluoxentine, were less attractive to male and so less likely to mate. Figure 3 gives idea about effect of drug on environment.

Figure3: Hazardous effect of drug on environment¹³.

Drugs such as antidepressants have been found in the United states great lakes researchers from the university of Buffalo have found high traces of antidepressants in brain of fish which results into behavior changes in the fish¹⁴.

2. Effect of antibiotic -

Antibiotics are also know as Antibacterial. Antibacterial drugs are used to treat various infectious diseases it act by killing or to stopping the growth of harmful bacteria. But these antibacterial agent may show advert effect. Antibacterials those which dispose onto the landfill under cultivation affects the soil microbes which have important role in breaking down pesticides which ultimate affect the production quantity and quality of crop. Prescence of tetracycline, macrolides and streptomycin also affect soil quality.

Ciprofloxacin is an antibiotic drug which is found on the surface water at maximum concentration of 30ng^-1. If 500ug/L of ciprofloxacin is exposed than it results in the reduction of Rhodobacteraceae and Nakamurellaceae. These bacteria are involved in key ecosystem function as it occurs in activated sluge microbial communities for waste water treatment it remove organic matter and Nitrogen. Other antibiotics such as sulphamethoxazole, lincomycin, chortertracycline are alsi detected in surface warer above 500ng^-1concentration. The antibiotic drug used in the livestock and pharmaceutical manufacturing when dissociate in water leads to death of fish¹⁵.

3. Effect of NACID and steroids:

Steroidal and Nonsteroidal anti-inflammatories are non-narcotic pain relievers. These medications are prescribed to reduce pain and inflammation in the body. ccorticosteroids are the most potent anti-inflammatory agents so they are over the counter drugs in certain countries. Because of their similarity in structure to endogenous hormones, they cause endocrine disruptions. Endocrine disruption is majorly caused by steroidal drug but non-steroidal can also harm endocrine system in aquatic organisms.

Prednisolone (synthetic corticosteroid) may end up in environment because of this immune depression and neurobehavioral changes have been reported. Development of feminized fish, disruption of normal growth of reptile, fish and aquatic organisms are also seen. Synthetic steroids such as 17a-Ethinylestradiol, methyltestosterone if found in concentrated amount can be harmful to aquatic species and the environment as shown in table 2.

Table 2: Synthetic Steroids and its effect.

S.No	Synthetic steroids	Reported effect
1)	17a-Ethinylestradiol	Endocrine disruption effect on invertebrates, fish, reptiles.
2)	Methyltestosterone	Oogenesis, spematogenesis, impersex, reduce facundity in snails.

U.K. researchers found that the growth of edible crops can be affected by traces of nonsteroidal anti-inflammatory drugs, even at very low concentration.

4. Effect of Inhaler:

Asthma is the most common disease which results into damage of the lung for such patients having COPD Inhaler is best choice for drug delivery.

There are three types of Inhalers -

1 Presurised metered dose Inhalers (pMDI)

2 Drug powered Inhalers (DPI)

3 Breath actuated Inhalers (BAIs)

These Inhalers containing propellant when goes into general waste may end up in landfill. If such container crush they may release hazardous propellant such as chlorofluorocarbons (CFCs) into atmosphere. This may lead to global warming, ozone layer depletion, freshwater aquatic ecotoxicity, abiotic depletion, human toxicity, marine aquatic ecotoxicity, acidification, eutrophication. Nowadays many countries have replaced chlorofluorocarbons by hydroflurocarbone (HFC) propellant. HFC do not have any effect on the ozone layer but they release powerful greenhouse gases and contribute to global warming. They have been replaced in many countries with HFA because of the concerns about CFCs damaging effect on the ozone layer. President meter dose inhalers and breath actuated inhalers have high carbon footprint than dry powdered inhalers. The impact of HFCs from inhalers on overall greenhouse gas emissions can be viewed from many perspectives. The impact of HFCs from inhelers on overall greenhouse¹⁶.

Internationally, HFC release from MDIs in 2014 was equivalent to 0.013 gt CO₂e, which was about 3% of global GWP-weighted CO₂e emissions of HFCs. They can be replaced in many countries with HFA because of the concern about CFCs¹⁷.

7. CONCLUSION:

There are various advantages of the pharmaceuticals to treat humans and animals but it also have the disadvantages in case of improper use of medicines, by looking at the amount at which the pollution of the environment due to the pharmaceuticals or various drugs this rartical may help to control the pollution. This may help to efficiently work on the classification and proper disposal of expired and unexpired drugs without causing any harm to the humans, animals, and environment, it may help to reduce the danger today and years to come. The implimentation of all these methods leads to the proper waste management and awareness in the society to control drug pollution.

8. REFERANCE:

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16. Christer Janson, Richar Hernderson, Magnus Lofdahl, Martin Hedberg, Raj Sharma, Alexander K Wilkinson. Carban footprint impact of the choise of inhalers for asthama and COPD. Thorax publication by BMJ and BTS. January 2020,75-1, 214-381.

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Received on 12.04.2021 Modified on 28.04.2021

Res. J. Pharma. Dosage Forms and Tech.2021; 13(3):247-252.

DOI: 10.52711/0975-4377.2021.00041