Citotoksični lijekovi - odgovoran i siguran rad zaštita zdravlja i okoliša - uloga ljekarnika

Cytotoxic drugs (antineoplastic drugs) are highly active drugs used in the chemotherapy of malignant diseases that cause numerous and serious side effects during treatment. As the incidence of tumor disease increases, the use of these drugs increases, especially in developed countries. Croatia belongs to the countries with a medium incidence, but high mortality from cancer, and it records a trend of increasing consumption of these drugs. Although cytotoxic/antineoplastic drugs ·are used at lower doses compared to other drugs, due to their nonselective action; they can cause various mutagenic, genotoxic and reproductive damages. Studies have shown a risk of diseases developing due to occupational exposure to cytotoxic/antineoplastic drugs and during the research, especially under conditions of inadequate protection, but also with the presence of cytotoxic drugs in various environmental systems, with concentrations varying up to 2.12 x 10-4 mg/L in different types of water. The toxic effect has been reported for aquatic organisms, and the question of the harmful effect on the entire ecosystem and ultimately on humans is being raised. The major sources of cytotoxic/antineoplastic drugs in the environment come from healthcare institutions, hospitals, industry, houshold, but also research. The patient who is the center of health professionals' care is also the holder of environmental responsibility since he/she contributes to the waste that ends up in the environment, either through excretion or through the improper disposal of such waste. Pharmacists are important health care stakeholders who can make a significant contribution in improving this problem because, based on their education and activities, they can participate in public health campaigns, change the public's awareness, educate the general population and the way they relate to the problem in each of these environmental cytotoxic/antineoplastic drugs sources. They can also foster green and sustainable pharmacy, innovation and the application of in silico methods, all together to preserve health and the environment