RESUMO
An increase in the temperature and the acidification of the aquatic environment are among the many consequences of global warming. Climate change can also negatively affect aquatic organisms indirectly, by altering the toxicity of pollutants. Models of climate change impacts on the distribution, fate and ecotoxicity of persistent pollutants are now available. For pharmaceuticals, however, as new environmental pollutants, there are no predictions on this issue. Therefore, this paper organizes the existing knowledge on the effects of temperature, pH and both stressors combined on the toxicity of pharmaceuticals on aquatic organisms. Besides lethal toxicity, the molecular, physiological and behavioral biomarkers of sub-lethal stress were also assessed. Both acute and chronic toxicity, as well as bioaccumulation, were found to be affected. The direction and magnitude of these changes depend on the specific pharmaceutical, as well as the organism and conditions involved. Unfortunately, the response of organisms was enhanced by combined stressors. We compare the findings with those known for persistent organic pollutants, for which the pH has a relatively low effect on toxicity. The acid-base constant of molecules, as assumed, have an effect on the toxicity change with pH modulation. Studies with bivalves have been were overrepresented, while too little attention was paid to producers. Furthermore, the limited number of pharmaceuticals have been tested, and metabolites skipped altogether. Generally, the effects of warming and acidification were rather indicated than explored, and much more attention needs to be given to the ecotoxicology of pharmaceuticals in climate change conditions.