1. 15 March 2009 – Disposing Unused Medicines- Mostaph Elhwary

3. Among the lay people 1. Throwing in the trash a. Homeless b. Pets c. Children

4. 2. Flushing in the Toilet two thirds of drug waste (EPA 2006) 1 Billion $ unused drugs are flushed into the toilet Neither is a GOOD method

5. Among the pharmacies 1. Sending back to the distributers 2. In the trash

6. Among the pharmaceutical companies  Batch incineration In the desert Egyptian ministry of health Special incinerators  Illegal drug labs Ecstasy and amphetamine Chemicals used Hazards of waste dumped

7. Among the hospitals  More hazardous drugs  AP: 250,000,000 pounds of drugs into sewer  Higher concentrations of antibiotic resistant bacteria

8. Impact of improper disposal on the environment 1. Damage to Aquatic life Decreased reproduction Alteration in homing behavior Ex. Diazinon on Salmon fish 2. Antibiotic resistance stronger bacteria resist antibiotics Harms on human

9. 3. Waste water treatment plan (WWTP) Damage of beneficial bacteria

11. Syringes and needles

12. Syringe disposal  WHO: 12 BILLION syringe a year in the world  Transmission of diseases Virus C AIDS

13.  Disposing in the trash 1. Cleaners 2. homeless 3. Recycling 4. KOSHARY & yoghurt

14. Solutions: Needle clipper Needle burner Retractable syringesSafety box

16. Proper disposal of PPCPs WHO, FDA stated that: 1. Check the pharmacy for a take-back program NO TAKE BACK PROGRAM 2. Check the city or state for a disposal program NO DISPOSAL PROGRAM 3. Check the police station for disposal box NO DISPOSAL BOX

17. Solid medication: Dissolve in water Mix with tea or coffee Double bag in a container

18. Liquid medications : ○ Marker or scratch ○ Add a PUNGENT ○ Add in container Safe in the toilet (FDA) Narcotics Fentanyl Oxycodone Entecavir Stavudine acetaminophen

19. Ampoules and vials : ○ Don’t open ○ Wrap ○ Pack in a container

20. CONFERENCES HELD IN DRUG DISPOSAL  2007 Northeast water science forum, Portland  IWTC10 2006, Alexandria, Egypt  Pharmaceutical waste reduction & discharge issue, February 2004

21. conclusion  Don’t throw in the trash UNLESS…..  Don’t flush in the toilet EXCEPT…..  Hope for a take-back program in 20….  Spread awareness to others