2024 年 27 巻 S1 号 p. S118-S131
Pharmaceuticals are produced and used with physiological effects on human and wildlife, and active pharmaceutical ingredients and their metabolites are discharged into the environment. In the environment, active pharmaceutical ingredients, with expected physiological effects, may coexist along with various substances and their environmental reaction products. Even if the concentrations of these substances individually do not cause load, there is a concern that their combined action may affect wildlife and indirectly human health. In particular, some active pharmaceutical ingredients have a common mechanism of action and a common site of action, and it is possible that combined actions may be existed. There are active pharmaceutical ingredients with a common structure involved in the mechanism of action and site of action, that can be used for group classification. In this paper, although the number of reports is limited, the outlines of combined actions of active pharmaceutical ingredients have been reviewed. The mechanism of combined actions is mainly able to be explained by additive actions, but there are also results that are thought to be synergistic actions, competitive antagonistic actions, and intermediate types of actions. It is necessary to understand the interaction among active pharmaceutical ingredients and to control to minimize the burden on human health and the environment.
