In coastal systems, pollutants as pharmaceutical drugs exert changes from the molecular to the organism level in marine bivalves. Besides pollutants, coastal systems are prone to changes in environmental parameters, as the alteration of salinity values because of Climate Change. Together, these stressors (pharmaceutical drugs and salinity changes) can exert different threats than each stressor acting individually; for example, salinity can change the physical-chemical properties of the drugs and/or the sensitivity of the organisms to them. However, limited information is available on this subject, with variable results, and for this reason, this study aimed to evaluate the impacts of salinity changes (15, 25 and 35) on the effects of the antiepileptic carbamazepine (CBZ, 1 μg/L) and the antihistamine cetirizine (CTZ, 0.6 μg/L), when acting individually and combined (CBZ + CTZ), in the edible clam Ruditapes philippinarum. After 28 days of exposure, drugs concentrations, bioconcentration factors and biochemical parameters, related to clam's metabolic capacity and oxidative stress were evaluated. The results showed that clams under low salinity suffered more changes in metabolic, antioxidant and biotransformation activities, in comparison with the remaining salinities under study. However, limited impacts were observed when comparing drug effects at low salinity. Indeed, it seemed that CTZ and CBZ + CTZ, under high salinity (salinity 35) were the worst exposure conditions for the clams, since they caused higher levels of cellular damage. It stands out that salinity changes altered the impact of pharmaceutical drugs on marine bivalves.

在沿海系统中，作为药物的污染物在海洋双壳类动物中产生从分子到生物体水平的变化。除了污染物外，沿海系统还容易发生环境参数的变化，因为气候变化会导致盐度值发生变化。总之，这些压力源（药物和盐度变化）可以产生不同的威胁，而不是每个压力源单独行动；例如，盐度会改变药物的物理化学特性和/或生物体对它们的敏感性。然而，关于该主题的可用信息有限，结果各不相同，因此，本研究旨在评估盐度变化（15、25 和 35）对抗癫痫药卡马西平（CBZ，1 μg/L）的影响) 和抗组胺药西替利嗪 (CTZ, 0.6 μg/L)，菲律宾蛤仔。暴露 28 天后，评估了与蛤的代谢能力和氧化应激相关的药物浓度、生物浓度因素和生化参数。结果表明，与所研究的其余盐度相比，低盐度下的蛤蜊在代谢、抗氧化和生物转化活动方面的变化更大。然而，在比较低盐度下的药物作用时，观察到的影响有限。事实上，在高盐度（盐度 35）下，CTZ 和 CBZ + CTZ 似乎是蛤蜊最糟糕的暴露条件，因为它们会导致更高水平的细胞损伤。值得注意的是，盐度变化改变了药物对海洋双壳类动物的影响。