Sue Brenan: Hello! I’m Sue Brenan, pharmacist with RxCo. Pharmacy and I am here to give you a pharmacy update of OTC cough and cold products for infants and children. On January 17th of 2008 the FDA issued a public health advisory for parents and caregivers and they recommended that over the counter which are the OTC cough and cold products should not be use to treat infants and children who are less than two years of age. And this is because of serious and potentially life threatening side effects that can occur from such use. The American Academy of Pediatrics and the CDC which is the center for disease control and prevention have also issued statement cautioning parents and caregivers. And this follows the FDA recommendation from last fall, were we have the voluntary removal of the OTC cough and cold products from the market, the products with pictures of infants and any leveling for use in children less than age 2. And this recommendation was base on finding that are was not evidence that the pediatric cold medicines really provided and a relief to children suffering from colds and they’re were growing reports of rapid heart rates, loss of consciousness, convulsions and even death associated with there used. And all the pharmacist got mailing from our wholesalers and we have lists of products that had to be taken off. Most medicines have not been specifically tested for safety in children and it was only until recently we trusted that the OTC medicines will basically safe for children as long as we will careful to give them in small doses. But when the expert review the evidence for antihistamines, nasal decongestants and cold serves they did not give them a very good report card. The cough and cold preparations are good examples of how medication that millions of people can use without worry maybe come unexpectedly lethal. A strong reaction to antihistamine is could include any of the following reactions; confusion, behavior problems and this is particularly important in children less than two of behavior problem might be the first sign that you would see that something is off. Often children less than two don’t have the ability to communicate very well about what’s wrong. Other system issues could be constipation, blurred vision, inability to urinate, dry skin and over heating. Decongestants on the other hand can be the heart rate, raise blood pressure cause sleep and behavior problems. I agree with this guidelines, if from medication is not very effective and its not work any risks however small especially with our infants and side effects can be unpredictable and more severe than in older kids. As we say in the trade, first do no harm. As this is now cough and colds season the FDA again is cautioning parents and caregivers against the use of OTC cough and cold products in children less than two years of age. There was some concern that parents may have not heard the initial warning may still have some other products in there homes even other no longer on the pharmacy shelves and may continue to give infants the OTC remedies. So, what’s the parent do? How is anybody going to get some sleep in this house tonight? Do we close the medicine cabinet and let your child’s cold run it curse. First of all infants who have cough and cold symptoms should be evaluated by there pediatrician or other health care provider. A persistent or productive cough in any age should require evaluation by physician or other primary care provider. Secondly, I know as parent you always want to find a way to make your kids feel better. In this case it maybe better to stick to TLC instead of OTC. There are many none pharmacologic measures that can be use, keeping an infant in an upright position can enhance nasal drainage. So positioning your child especially at night so that his or her head is lifted higher than usual, this can be particularly helpful for a baby who is breastfeeding. Also maintaining adequate fluid intake, have your child drink