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Further on the spring agenda is a meeting in Washington on sustainable development of pharmaceuticals including a presentation of the MistraPharma research hydrocodone m365 and a possibility of collaboration with the USA. Together we should take the responsibility of sustainable development for pharmaceuticals into the future thus ensuring that the international policies set up by the UN and the EU will result in concrete measures.

Christina R Akerman Director General of the Swedish Medical Products Agency Member of the MistraPharmas Programme Board Summary Sammanfattning 1 2 3 4 5 6 7 39 36 46 58 72 80 98 106 118 130 140 Bioconcentration of Pharmaceuticals Jerker Fick, Roman Grabic, D.G. Joakim Larsson, Richard H Lindberg and Mats Tysklind The Frog Test System Cecilia Berg Genomics as a Guide for Environmental Risk Assessment of Pharmaceuticals Filip Cuklev, Lina Gunnarsson and D.G. Joakim Larsson Laboratory vs Field Studies to Assess Environmental Hazards and Risks Posed by Pharmaceuticals for Human use Ingvar Brandt and Bjorn Brunstrom Standard and Non-standard Tests for Risk Assessment Purposes Christina Ruden, Marlene Agerstrand, Malena Goransson and Magnus Breitholtz WikiPharma - A Database with Environmental Effect Data for Pharmaceuticals Linda Molander, Marlene Agerstrand and Christina Ruden The Swedish Environmental Classification and Information System for Pharmaceuticals.

An Evaluation of the System's Achievements so far Marlene Agerstrand and Christina Ruden Swedish Wastewater Treatment Plants and Their Ability to Remove Pharmaceuticals Per Falas and Jes la Cour Jansen The Vision - Sustainable Pharmaceutical Management in a Sustainable Society Ake Wennmalm, Bengt-Erik Bengtsson and Bo Gunnarsson Authors Summary hydrocodone m365 The research programme "MistraPharma - Identification and Reduction of Environmental Risks Caused by the Use of Human Pharmaceuticals" is financed by the Swedish Foundation for Strategic Research (Mistra). The programme consists of seven partners: Goteborg University, the Royal Institute of Technology, Lund University, Umea University, Uppsala University, Stockholm University, and Goodpoint AB. The overall objectives of MistraPharma are: 1.To identify human pharmaceuticals that pose a significant risk to organisms in the aquatic environment 2.To propose recommendations to improve wastewater treatment technologies 3.To suggest strategies for early identification of human pharmaceuticals that may pose a threat to aquatic species, and 4. To strengthen the network between stakeholders in this hydrocodone codeine phosphate field MistraPharma started in January 2008 and its first phase will be finalized at the end of 2011. In this volume we summarize the programme's main achievements so far. In chapter 1 (Bioconcentration of pharmaceuticals, by Jerker Fick, Roman Gra- bic, Richard Lindberg, Joakim Larsson and Mats Tysklind) an essential part of the MistraPharma research approach is described, namely the procedure of prioritizing pharmaceuticals based on empirical bioconcentration studies and the "plasma model"1. The plasma model is based on the assumption that two species sharing the same drug target, i.e.

a receptor or an enzyme, will require about hydrocodone m365 the same plasma concentrations of a pharmaceutical to activate a pharmacological response. Comparing the human therapeutic plasma concentration hydrocodone m365 for a particular pharmaceutical to the measured steady state levels in fish hydrocodone m365 blood plasma thus makes it possible to estimate the likelihood that the fish is pharmacologically affected by that drug. Within MistraPhar- ma all the 1200 active pharmaceutical ingredients available on the Swedish market were initially considered. Using a theoretical model, risk estimates for these substances were calculated and based on this 120 active pharmaceutical ingredients were prioritized for further scrutiny. Empirical determination of bioconcentration for 25 of these pharmaceuticals was investigated in rainbow trout exposed to effluent water from three Swedish sewage treatment plants.

Out of the 25 selected pharmaceuticals, 17 were detected in fish plasma.

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