The discovery of therapeutic medicinal products has historically been largely accidental, through trial and error involving observation of the therapeutic effects of "naturally" produced compounds such as penicillin from the mold Penicillium notatum (Fleming 1929), salicylic acid from the bark of willow trees ( Salix ) (Mackowiak 2000), and lovastatin from the fungal microorganism Aspergillus terreus (Bach and Lichtenthaler 1982a), with little or no preconceived knowledge of effect. Currently, however, the pharmacokinetics and pharmacodynamics of these compounds are well understood. However, amid all the research and development of synthetic analogues and derivatives, the original functions of these compounds, as they relate to the organisms in which they were discovered, appear to have been forgotten. The consequence, however, becomes readily apparent when considering the ecotoxicology of Pharmaceuticals, particularly because these compounds are biologically active and produced to affect other organisms. Because there are numerous examples of evolutionary conservation of pathways and receptor targets within and among levels of biological organization, it stands to reason that Pharmaceuticals derived, synthesized, and inspired from these naturally produced compounds could ultimately induce toxic effects in nontarget organisms. Recent research supports this notion, and this review discusses potential evolutionary conserved targets to, general effects from, and the risks posed by Pharmaceuticals in nontarget aquatic plants. © 2008 Springer.