Pharmaceuticals as Pollutants in the Aquatic Ecosystem – Cardiovascular, Anti-diabetic, Steroids and Related Drugs

Drugs like \(\beta\)-blockers (atenolol, propranolol, metoprolol), ACE inhibitors (captopril, enalapril, lisinopril,  ramipril,  fosinopril,  quinapril),  angiotensin  (AT1)  receptor blockers  (losartan, candesartan, valsartan, telmisartan), \(\alpha\)-blockers (prazosin, terazosin, doxazosin, phentolamine, phenoxybenzamine), central sympatholytics (clonidine, methyldopa), cardiac glycosides (digoxin,  digitoxin),  sympathetic  drugs (adrenaline,  dopamine,  isoprenaline),  anticholinergic drugs   (atropine,  scopolamine),  xanthines  (theophylline,  theobromine),  nitrates  (glyceryl trinitrate, isosorbide dinitrate), calcium antagonists (verapamil, diltiazem) and K-channel openers (nicorandil) are used for the treatment of the cardiovascular disorder [1].  Recently a study was conducted on the occurrence  of cardiovascular drugs in surface waters at a global scale. The study had 82 cardiovascular drugs out of which 58 (~71%) were detected at least once in the water bodies. The study also revealed that only 10% of the aquatic pollution was caused by the commonly prescribed antihypertensives (6% by angiotensin receptor-II antagonist and 4% by ACE inhibitors). The maximum contribution as a source  of pollutants were from \(\beta\)-blockers (atenolol, metoprolol, and propranolol) at 38% and 36% to lipid regulating agents (gemfibrozil, bezafibrate and clofibric acid). The ecotoxicity caused by these cardiovascular drugs was further limited to  about  24%.  The  drugs  that are  a  major  risk to  the  aquatic organisms include propranolol, metoprolol, lipid regulating agents,  bezafibrate, and  atorvastatin. The partition coefficient (Log P) value of cardiovascular drugs ranges from  0.6 for  atenolol to  7.7  for telmisartan that results in bioaccumulation in the environmental matrices. Based on the presence of cardiovascular drugs in the aquatic ecosystem, the water pollutants are divided into three major contaminants, municipal water, surface water, and drinking water.