Journals / Veteriner Farmakoloji ve Toksikoloji Derneği Bülteni / 2026 / Cilt: 17 Sayı: 2026

Disposal Practices and Environmentally Safe Management of Pharmaceutical Waste

İlaç Atık Sınıfı Bertaraf Uygulamaları ve Çevresel Açıdan Güvenli Yönetimi

Nimet Kılıç(AYDIN ADNAN MENDERES ÜNİVERSİTESİ, AYDIN SAĞLIK HİZMETLERİ MESLEK YÜKSEKOKULU)0000-0003-2149-388X
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Publication Date
2026-07-17
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This review article aims to present current information on methods used to dispose of expired or damaged medicines in a manner that does not harm the environment or human health (incineration, autoclaving, encapsulation, deep burial, etc.) and on the environmental risks of unsafe medicine disposal and appropriate disposal methods.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Medicines, which are an important component of preventive and therapeutic healthcare services, exhibit desired biological effects in human or animal organisms.
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Key Findings & Data:In households, drug waste is commonly disposed of in the trash, flushed down the toilet, poured down the sink, or incinerated.
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Conclusion & Impact:This review article aims to present current information on methods used to dispose of expired or damaged medicines in a manner that does not harm the environment or human health (incineration, autoclaving, encapsulation, deep burial, etc.) and on the environmental risks of unsafe medicine disposal and appropriate disposal methods.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Atık yönetimi · çevre kirliliği · ilaç atıkları

Abstract

Medicines, which are an important component of preventive and therapeutic healthcare services, exhibit desired biological effects in human or animal organisms. In addition to these known properties, the effects of drugs on organisms are considered alarming due to the disposal of active drug components or unused drugs that are discarded when their effects wear off. One of the major sources of drug waste entering the environment is generally unplanned management and disposal. In households, drug waste is commonly disposed of in the trash, flushed down the toilet, poured down the sink, or incinerated. This situation has negative impacts on public and environmental health. Therefore, safe pharmaceutical waste management is an important element in protecting environmental health. Because pharmaceutical waste can adversely affect human health and create environmental risks when released directly or indirectly into receiving environments, it is of great importance that this issue be examined comprehensively. Proper pharmaceutical waste management without harming the environment largely depends on planned management and organization, as well as increasing education and awareness about the disposal of waste using methods that are compatible with the environment and legislation. This review article aims to present current information on methods used to dispose of expired or damaged medicines in a manner that does not harm the environment or human health (incineration, autoclaving, encapsulation, deep burial, etc.) and on the environmental risks of unsafe medicine disposal and appropriate disposal methods.

Özet

Koruyucu ve tedavi edici sağlık hizmetlerinin önemli bir unsuru olan ilaçlar, insan veya hayvan organizmalarında istenilen biyolojik etkiler göstermektedir. Bilinen bu özelliklerinin yanında organizmada etkilerinin sonlanması sonucunda atılan aktif ilaç bileşenleri veya artık ihtiyaç duyulmayan ilaçların bilinçsiz şekilde salınmasıyla çevreye olan etkileri endişe verici olarak nitelendirilmiştir. İlaç atıklarının çevreye karışmasının önemli kaynaklarından biri genelde plansız yönetimi ve bertarafıdır. Hanelerde ilaç atıkları yaygın şekilde çöpe, tuvalete, lavaboya atılarak ya da yakılarak imha edilmektedir. Bu durum halk ve çevre sağlığı üzerinde olumsuz etkiler meydana getirmektedir. Bu yüzden güvenli ilaç atık yönetimi, çevre sağlığını korumanın önemli bir unsurudur. İlaç atıklarının insan sağlığına zarar verebilmesi ve doğrudan ya da dolaylı olarak çevreye verilmesinin risk oluşturması nedeniyle bu konunun kapsamlı şekilde incelenmesi büyük önem taşımaktadır. İlaç atık yönetiminin çevreye zarar vermeden uygun şekilde yapılabilmesi büyük oranda planlı yönetim ve organizasyonun yanı sıra atıkların çevre ve mevzuatla uyumlu yöntemlerle bertarafı hakkında eğitimin ve farkındalığın artırılmasına bağlıdır. Bu derleme makale, son kullanma tarihi geçmiş ya da ambalajı bozulmuş ilaçların çevreye ve insan sağlığına zarar vermeyecek şekilde bertarafında kullanılan yöntemleri (yakma, otoklavlama, kapsülleme, derin gömme vb.) ve güvenli olmayan ilaç imhasının çevresel riskleri ile uygun imha yöntemleri hakkında mevcut bilgileri sunmayı amaçlamaktadır.

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Cite This Article

Kılıç, N. (2026). Disposal Practices and Environmentally Safe Management of Pharmaceutical Waste. Veteriner Farmakoloji ve Toksikoloji Derneği Bülteni, Cilt: 17 Sayı: 2026. https://doi.org/10.38137/vftd.1897016

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References (97)

  1. Ahmad S, Jaiswal R, Yadav R. & Verma S. (2024). Recent advances in green chemistry approaches for pharmaceutical synthesis. Sustainable Chemistry One World, 4(9), 100029.
  2. Akici A, Aydin V & Kiroglu A. (2018). Assessment of the association between drug disposal practices and drug use and storage behaviors. Saudi Pharmaceutical Journal, 26(1), 7-13.
  3. Albero B, Sánchez-Brunete C, García-Valcárcel AI, Pérez RA &Tadeo JL. (2015). Ultrasound-assisted extraction of emerging contaminants from environmental samples, TrAC Trends in Analytical Chemistry, 71,110-118.
  4. Alhamad H, Patel N. & Donyai P. (2020). Towards Medicines Reuse: A Narrative Review of the Different Therapeutic Classes and Dosage Forms of Medication Waste in Different Countries. Pharmacy (Basel), 8(4), 230.
  5. AlSalman AH, AlKhamis AA, Binsaleh EM, Gadeemi AA, AlJuhar AA et al. (2025). Literature Review: Pharmaceutical Waste Disposal Practices: Global Trends and Environmental Impact. World Journal of Biology Pharmacy and Health Sciences, 23(3), 128-130.
  6. Anastas P T & Kirchhoff MM. (2002). Origins, Current Status, and Future Challenges of Green Chemistry. Accounts of Chemical Research, 35(9), 686-694.
  7. aus der Beek T, Weber FA, Bergmann A, Hickmann S, Ebert I et al. (2016). Pharmaceuticals in the environment--Global occurrences and perspectives. Environmental Toxicology Chemistry, 35(4), 823-35.
  8. Ayele Y & Mamu M. (2018). Assessment of knowledge, attitude and practice towards disposal of unused and expired pharmaceuticals among community in Harar city, Eastern Ethiopia. Journal of Pharmaceutical Policy and Practice, 11(1), 27.
  9. Babu MA. (2016). A short review on pharmaceutical waste disposal and management. Journal of Pharmaceutics and Nanotechnology, 4(2), 1-7.
  10. Baroka IU. (2025). Pharmaceutical waste management: sources, environmental Impacts, and sustainable solutions. Pharmacy Reports, 5(1), 95.
  11. Bataduwaarachchi VR. & Weeraratne CL. (2016). Global medication waste management practices: challenges and opportunities in developing countries. International Journal of Basic & Clinical Pharmacology, 5(6), 2290-2294.
  12. Bhattacharyya S & Bhowmick A. (2021). Pharmaceutical Waste Management - A Study. Acta Scientific Pharmaceutical Sciences, 5(12), 63-68.
  13. Blenkharn JI. (2006). Medical wastes management in the south of Brazil. Waste Management, 26(3), 315-317.
  14. Birnbaum LS & Fenton SE. (2003). Cancer and developmental exposure to endocrine disruptors. Environmental Health Perspectives, 111(4), 389-94.
  15. Boxall AB, Fogg LA, Blackwell PA, Kay P, Pemberton EJ et al. (2004). Veterinary medicines in the environment. Reviews of Environmental Contamination Toxicology, 180, 1-91.
  16. Bungau S, Tit DM, Fodor K, Cioca G, Agop M et al. (2018). Aspects Regarding the Pharmaceutical Waste Management in Romania. Sustainability, 10(8), 2788.
  17. Chandrappa R & Das DB. (2012). Chapter 6: Biomedical Waste. In: Solid Waste Management, Springer, Berlin, Heidelberg, 147-175.
  18. Daughton CG & Brooks BW. (2011). Active Pharmaceutical Ingredients in Aquatic Organisms. In: Beyer, W.N. and Meador, J.P., Eds., Environmental Contaminants in Biota: Interpreting Tissue Concentrations, Chapter 8, 2nd Edition, CRC Press, Boca Ratton, 286-347.
  19. Deshkar AT, Gawali UP & Shirure PA. (2018). Environmental pharmacology: an emerging science. International Journal of Basic & Clinical Pharmacology, 7 (3), 359-362.
  20. Drummond I, Bains R, Dosanjh A, Ladhar S, Tang L et al. (2023) Recycling unused medications in hospitals is financially viable and good for the environment. International Journal of Pharmacy Practice, 31(5), 562-564.
  21. Du L & Liu W. (2012). Occurrence, fate, and ecotoxicity of antibiotics in agro-ecosystems. A review. Agronomy for Sustainable Development, 32(2), 309-327.
  22. Fleming E, Proescholdbell S, Sachdeva N, Alexandridis AA, Margolis L et al. (2016). North Carolina's Operation Medicine Drop: Results From One of the Nation's Largest Drug Disposal Programs. NC Med J., 77(1), 59-62.
  23. Fram MS & Kenneth B. (2011). Occurrence and concentrations of pharmaceutical compounds in groundwater used for public drinking-water supply in California. Science of the Total Environment, 409 (18), 3409-17.
  24. Fent K, Weston AA & Caminada D. (2006). Ecotoxicology of human pharmaceuticals. Aquatic Toxicology, 76(2), 122-59.
  25. Furlong ET, Batt AL, Glassmeyer ST, Noriega MC, Kolpin DW et al. (2017). Nationwide reconnaissance of contaminants of emerging concern in source and treated drinking waters of the United States: Pharmaceuticals. Science of the Total Environment, 579, 1629-1642.
  26. Glassmeyer ST, Furlong ET, Kolpin DW, Cahill JD, Werner SL et al. (2005). Transport of chemical and microbial contaminants from known wastewater discharges: Potential for use as indicators of human fecal contamination. Environmental Science and Technology, 39(14), 5157-5169.
  27. Gworek B, Kijeńska M, Wrzosek J & Graniewska M. (2021). Pharmaceuticals in the Soil and Plant Environment: a Review. Water Air Soil Pollution, 232 (4), 145.
  28. Gyllenhammar I, Holm L, Eklund R & Berg C. (2009). Reproductive toxicity in Xenopus tropicalis after developmental exposure to environmental concentrations of ethynylestradiol. Aquatic Toxicology, 91(2), 171-178.
  29. Hanna N, Sun P, Sun Q, Li X, Yang X et al. (2018). Presence of antibiotic residues in various environmental compartments of Shandong province in eastern China: Its potential for resistance development and ecological and human risk. Environment International, 114, 131-142.
  30. Harhay MO, Halpern SD, Harhay JS & Olliaro PL. (2009). Health care waste management: a neglected and growing public health problem worldwide. Tropical Medicine & International Health, 14(11), 1414-7.
  31. Holm JV, Ruegge K, Bjerg PL & Christensen TH. (1995). Occurrence and distribution of pharmaceutical organic compounds in the ground water downgradient of a landfill (Grinsted, Denmark). Environ. Sci. Technol.,29(5), 1415-1420.
  32. Hossain MS, Santhanam A, Norulaini NA & Omar AKM. (2011). Review on: Clinical solid waste management practices and its impact on human health and environment. Waste Management, 31(4), 754-766.
  33. Ingale MH, Tayade MC, Patil YP, & Salunkhe RH. (2023). Pharmaceutical waste disposal current practices and regulations: rewiev. IJPQA International Journal of Pharmaceutical Quality Assurance, 14(3), 821-824.
  34. Ionescu A-M & Cazan C. (2024). Pharmaceutical Waste Management: A Comprehensive Analysis of Romanian Practices and Perspectives. Sustainability, 16(15), 6571.
  35. Jaseem M, Kumar P & John RM. (2017). An overview of waste management in pharmaceutical industry‖, The Pharma Innovation Journal, 6(3), 158-161.
  36. Kadam A, Patil S, Patil S & Tumkur A. (2016). Pharmaceutical waste management an overview. Indian Journal of Pharmacy Practice, 9(1), 2-8.
  37. Karthikeyan KG & Meyer MT. (2006). Occurrence of antibiotics in wastewater treatment facilities in Wisconsin, USA. Sci. Total Environ., 361(1-3), 196-207.
  38. Karungamye P, Rugaika A, Mtei K, & Machunda R. (2022). The pharmaceutical disposal practices and environmental contamination: A review in East African countries. HydroResearch, 5(5), 99-107.
  39. Kayode-Afolayan SD, Ahuekwe EF, & Nwinyi OC. (2022). Impacts of pharmaceutical effluents on aquatic ecosystems. Scientific African, 17, e01288.
  40. Khan U, Bloom RA, Nicell JA & Laurenson JP. (2017). Risks associated with the environmental release of pharmaceuticals on the U.S. Food and Drug Administration "flush list". The Science of the Total Environment, 609, 1023-1040.
  41. Khatri J, Shakya R, Shrestha R & Shrestha S. (2025). Disposal of unused and expired medications: A study of knowledge, attitudes, and practices among community pharmacy visitors. SAGE Open Medicine, 13, 20503121251375355.
  42. Kidd KA, Blanchfield PJ, Mills KH, Palace VP, Evans RE et al. (2007). Collapse of a fish population after exposure to a synthetic estrogen. Proceedings of the National Academy of Sciences of the United States of America, 104 (21), 8897-901.
  43. Kinrys G, Gold AK & Nierenberg AA. (2016). Proper drug disposal: studying a solution to household prescription and over-the-counter drug abuse. Journal Drug Abuse, 2(2), 1–7.
  44. Kiranmayi B, Arvapalli S, Sharma JVC. & Sushma V. (2019). Pharmaceutical Waste Management- A Review. Journal of Pharma Research, 8(10), 669-675.
  45. Kodešová R, Kočárek M, Klement A, Golovko O, Koba O et al. (2016). An analysis of the dissipation of pharmaceuticals under thirteen different soil conditions. Science of the Total Environment, 544, 369-381.
  46. Kusturica MP, Jevtic M & Ristovski JT. (2022). Minimizing the environmental impact of unused pharmaceuticals: Review focused on prevention. Frontiers in Environmental Science, 10, 10777974.
  47. Kruopienė J & Dvarionienė J. (2007). Pharmaceutical pathways to the environment in Lithuania. Environmental research, engineering and management, 41(3), 33-39.
  48. Kümmerer K. (2009). The presence of pharmaceuticals in the environment due to human use—Present knowledge and future challenges. J. Environ. Manag., 90(8), 2354-2366.
  49. Law AV, Sakharkar P, Zargarzadeh A, Tai BW, Hess K et al. (2015). Taking stock of medication wastage: Unused medications in US households. Research in Social and Administrative Pharmacy, 11(4),571-8.
  50. Lee BK, Ellenbecker MJ & Moure-Ersaso R. (2004). Alternatives for treatment and disposal cost reduction of regulated medical waste. Waste Management, 24(2), 143-151.
  51. Leite M, Freitas A, Cenáculo D, Bessa F, Pardal MA et al. (2025). Pharmaceuticals in coastal sediments: validation of a Ultra-High-Performance Liquid Chromatography coupled with Time-of-Flight Mass Spectrometry (UHPLC-TOF-MS) methodology. Environmental Pollution, 380,126571.
  52. Li D, Chen H, Liu H, Schlenk D, Mu J et al. (2021). Anticancer drugs in the aquatic ecosystem: Environmental occurrence, ecotoxicological effect and risk assessment. Environment International, 153(15), 106543.
  53. Liu J, Li H, Liu Z, Meng X, He Y et al. (2022). Study on the process of medical waste disinfection by microwave technology. Waste Management, 150(23),13-19.
  54. Löffler D, & Ternes TA. (2003). Determination of acidic pharmaceuticals, antibiotics and ivermectin in river sediment using liquid chromatography–tandem mass spectrometry. Journal of chromatography A, 1021(1-2), 133-144.
  55. Manyele SV & Lyasenga TJ. (2010). Factors affecting medical waste management in lowlevel health facilities in Tanzania. African Journal of Environmental Science and Technology, 4 (5), 304-318.
  56. Mezzelani M, Gorbi S. & Regoli F. (2018). Pharmaceuticals in the aquatic environments: evidence of emerged threat and future challenges for marine organisms. Marine environmental research, 140, 41-60.
  57. Mišík M, Pichler C, Rainer B, Filipic M, Nersesyan A et al. (2014). Acute toxic and genotoxic activities of widely used cytostatic drugs in higher plants: Possible impact on the environment. Environmental Research, 135, 196-203.
  58. Mohammed SA, Kahissay MH & Hailu AD. (2021). Pharmaceuticals wastage and pharmaceuticals waste management in public health facilities of Dessie town, North East Ethiopia. PLoS One, 16(10), e0259160.
  59. Muambo KE, Kim MG, Kim DH, Park S & Oh JE. (2024). Pharmaceuticals in raw and treated water from drinking water treatment plants nationwide: Insights into their sources and exposure risk assessment. Water Research X, 24 (2), 100256.
  60. Mukhtar S, Khan H, Kiani Z, Nawaz S, Zulfiqar S et al. (2018). Hospital waste management: execution in Pakistan and environmental concerns-a review. Environmental Contaminants Reviews (ECR), 1(1), 13-7.
  61. Oaks JL, Gilbert M, Virani MZ, Watson RT, Meteyer CU et al. (2004). Diclofenac residues as the cause of vulture population decline in Pakistan. Nature, 427(6975), 630-3.
  62. Ohoro CR, Adeniji AO, Okoh AI & Okoh OO. (2019). Distribution and chemical analysis of pharmaceuticals and personal care products (PPCPs) in the environmental systems:a review. International Journal of Environmental Research and Public Health, 16 (17), 3026.
  63. Ojukwu UC, Arthur C, Jonathan W, Ehigiegba OJ, Yussuf MD et al. (2025). Green Chemistry in Pharmaceutical Synthesis: Implications for Sustainable Public Health. European Journal of Scientific Research and Reviews, 3 (1), 1-18.
  64. Omuferen LO, Maseko B & Olowoyo JO. (2022). Occurrence of antibiotics in wastewater from hospital and convectional wastewater treatment plants and their impact on the effluent receiving rivers: current knowledge between 2010 and 2019. Environmental Monitoring and Assessment, 194(4), 306.
  65. O’neill J. (2014). Antimicrobial resistance: tackling a crisis for the health and wealth of nations. The review on antimicrobial resistance, 20, 1-16.
  66. Organisation for Economic Co-operation and Development (OECD) (2022). Management of pharmaceutical household waste: Limiting environmental impacts of unused or expired medicine. Paris, France: OECD Publishing. Erişim adresi: https://doi.org/10.1787/3854026c-en. Erişim tarihi: 10.12.2025.
  67. Ortúzar M, Esterhuizen M, Olicón-Hernández DR, González-López J, & Aranda E. (2022). Pharmaceutical Pollution in Aquatic Environments: A Concise Review of Environmental Impacts and Bioremediation Systems. Frontiers in Microbiology, 13, 869332.
  68. Pratyusha K, Gaikwad NM, Phatakk AA & Chaudhari PD. (2012). Review on: Waste Material Management in Pharmaceutical Industry. International Journal of Pharmaceutical Sciences Review and Research, 16(2), 121-129.
  69. Polianciuc SI, Gurzau AE, Kiss B, Stefan MG & Loghin F. (2020). Antibiotics in the environment: Causes and consequences. Medicine and Pharmacy Reports., 93(3), 231-240.
  70. Rajat Ankalgi AD, Chaudhary S & Ashawat MS. (2022). Challenges and Current Perspectives of Medical Pharmaceutical Waste Management. Ymer digital, 21(8), 897-919.
  71. Rajbongshi S, Shah YD & Sajib AU. (2016). Pharmaceutical waste management: a review. European Journal of Biomedical and Pharmaceutical Sciences, 3(12), 192-206.
  72. Ravinetto R, Lates J, Jonkman L, Nangombe V, Hauner A et al. (2025). Inadequate last-mile pharmaceutical waste management is a neglected threat to environmental and public health: A call to action. BMJ global health, 10(7), e019544.
  73. Rogowska J & Zimmermann A. (2022). Household Pharmaceutical Waste Disposal as a Global Problem-A Review. Int J Environ Res Public Health, 19(23), 15798.
  74. Ruhoy IS & Daughton CG. (2007). Types and quantities of leftover drugs entering the environment via disposal to sewage—Revealed by coroner records. Sci.Total Environ.,388 (1-3), 137-48.
  75. Samal K, Mahapatra S & Ali Md H. (2022). Pharmaceutical wastewater as Emerging Contaminants (EC): Treatment technologies, impact on environment and human health. Energy Nexus, 6(1),100076.
  76. Santos HMLM, Gros M, Rodriguez-Mozaz S, Delerue-Matos C, Pena A et al. (2013). Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals. Science of the Total Environment, 461-462, 302-316.
  77. Serwecińska L. (2020). Antimicrobials and Antibiotic-Resistant Bacteria: A Risk to the Environment and to Public Health. Water, 12 (12), 3313.
  78. Shinde AR, Patil AP, Patil TM, Vakhariya Mr RR & Magdum Dr CS. (2020). Pharmaceutical waste management: significant for health of nature and future. Internatıonal journal, 65(2), 68-74.
  79. Stewart H, Malinowski A, Ochs L, Jaramillo J, McCall K et al. (2015). Inside Maine's Medicine Cabinet: Findings From the Drug Enforcement Administration's Medication Take-Back Events. American Journal of Public Health, 105(1), e65-e71.
  80. Sim WJ, Lee JW, Lee ES, Shin SK, Hwang SR et al. (2011). Occurrence and distribution of pharmaceuticals in wastewater from households, livestock farms, hospitals, and pharmaceutical manufacturers. Chemosphere, 82(2),179-86.
  81. Singh S, Prakash V. (2007). Toxic environmental releases from medical waste incineration: a review. Environmental Monitoring and Assessment, 132 (1-3), 67-81.
  82. Sui Q, Cao X, Lu S, Zhao W, Qiu Z et al. (2015). Occurrence, sources and fate of pharmaceuticals and personal care products in the groundwater: A review. Emerging Contaminants, 1(1), 14-24.
  83. Ternes TA. (1998). Occurrence of drugs in German sewage treatment plants and rivers. Water Research, 32(11), 3245-3260.
  84. Tijani JO, Fatoba OO & Petrik LF. (2013). A review of pharmaceuticals and endocrine disrupting compounds: Sources, effects, removal, and detections. Water Air Soil Pollut., 224 (1770), 1-29.
  85. Tong AY, Peake BM & Braund R. (2011). Disposal practices for unused medications around the world. Environment International, 37(1), 292-8.
  86. Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA et al. (2015). Global trends in antimicrobial use in food animals. Proceedings of the National Academy of Sciences U S A, 112 (18), 5649-5654.
  87. Vatovec C, Kolodinsky J, Callas P, Hart C & Gallagher K. (2021). Pharmaceutical pollution sources and solutions: Survey of human and veterinary medication purchasing, use, and disposal. Journal of Environmental Management, 285(3), 112106.
  88. Wang J & HuX. (2014). Ecopharmacovigilance: Currentstate, challenges and opportunities in China. Indian Journal Pharmacology, 46(1),13-7.
  89. Wang J, Shen J, Ye D, Yan X, Zhang Y et al. (2020). Disinfection technology of hospital wastes and wastewater: suggestions for disinfection strategy during coronavirus disease 2019 (COVID-19) pandemic in China. Environmental. Pollution, 262,114665.
  90. Wise R. (2002). Antimicrobial resistance: Priorities of action. Journal of Antimicrobial Chemotherapy, 49(4), 585-6.
  91. World Health Organization (WHO) (2014). Safe management of wastes from health-care activities, second edition. Erişim adresi: https://www.who.int/publications/i/item/9789241548564. Erişim tarihi: 22.12.2025.
  92. World Health Organization (WHO) (2025). Safe management of pharmaceutical waste from health care facilities: global best practices. Erişim adresi: https://www.who.int/publications/i/item/9789240106710. Erişim tarihi: 22.12.2025.
  93. Xiang Y, Wu H, Li L, Ren M, Qie H et al. (2021). A review of distribution and risk of pharmaceuticals and personal care products in the aquatic environment in China. Ecotoxicol Environ Saf., 213,112044.
  94. Yadav SK, Kumar R & Kumar B. (2025). Green synthesis strategies in pharmaceutical industries for sustainable growth. International Journal of Chemical Studies, 13(5), 56-63.
  95. Yanovitzky I. (2016). The American Medicine Chest Challenge: Evaluation of a Drug Take-Back and Disposal Campaign. Journal of Studies on Alcohol and Drugs,77(4), 549-55.
  96. Zhang QQ, Ying GG, Pan CG, Liu YS & Zhao JL. (2015). Comprehensive evaluation of antibiotics emission and fate in the River Basins of China: source analysis, multimedia modeling, and linkage to bacterial resistance. Environmental Science and Technology, 49(11), 6772-6782.
  97. Zhang QQ, Ying GG, Pan CG, Liu YS & Zhao JL. (2015). Comprehensive evaluation of antibiotics emission and fate in the River Basins of China: source analysis, multimedia modeling, and linkage to bacterial resistance. Environmental Science and Technology, 49(11), 6772-6782.