Pharmaceutical compounds and their toxicity to marine organisms: Emerging contaminants and innovative strategies to reduce pharmaceutical pollution - A review and meta-analysis.

Pharmaceutical pollution in coastal and marine environments poses a serious threat to aquatic organisms. This article provides a critical overview of the toxicological impacts of commonly used classes of drugs, including antibiotics, anticancer, antidepressants, antihypertensives, and analgesics, on coastal and marine organisms. This review highlights how these pharmaceuticals affect growth, reproduction, development, physiology, behaviors, and mortality changes in coastal and marine organisms. In particular, antibiotics contribute to the emergence of antibiotic-resistant bacteria in marine ecosystems, whereas analgesics and antidepressant drugs alter normal marine animal behavior and impair reproductive patterns. Additionally, antihypertensive drugs, particularly beta-blockers, interfere with cardiovascular physiology, reducing heart rate and altering blood pressure regulation in marine fish. They also disrupt gill ion transport, osmoregulation, and metabolic performance in marine mollusks and crustaceans, resulting in reduced growth, reproduction, and resilience, ultimately threatening ecosystem stability and biodiversity. This review also summarizes the environmental concentration of those drugs found in coastal and marine waters. Beyond antibiotics, analgesics, antidepressant medicines, and anticancer agents are also acutely toxic and pose a severe health risk even at short-term exposure. Importantly, this article systematically reviews the various pharmaceutical compounds in seawater and highlights the urgent need to control pollution from these sources. Specific steps are outlined to reduce pharmaceutical pollution by improving wastewater management, strengthening regulatory processes, and promoting green chemistry solutions. This review compiles and evaluates recent findings on the occurrence, bioaccumulation, and toxicological impacts of pharmaceuticals in marine organisms, while identifying key knowledge gaps and emerging ecological concerns. This study also provides a comprehensive overview of pharmaceutical contamination in marine environments and emphasizes the urgent need for monitoring and mitigation. In addition, the review outlines future research to understand the long-term consequences of pharmaceutical pollutants better and to develop innovative strategies and management techniques to mitigate their impact on coastal and marine ecosystems.