The Royal Baby and Pharma

Yes, of course, there is a connection between Duchess of Cambridge Kate Middleton giving birth Monday to the Royal Baby and the pharmaceutical industry in Philadelphia.

Beyond the blatant desire of PhillyPharma to drive traffic to, pharmaceutical companies GlaxoSmithKline and AstraZeneca have Philly-area operations and headquarters in London, site of the royal baby's birth. GSK chief executive Andrew Witty received a knighthood after landing on Queen Elizabeth II's New Year's Honors List, though it's unclear whether that has impressed the Chinese officials currently claiming to be unhappy with the marketing habits of some GSK folks inside China. Prince Harry, younger brother of new father, Prince William, was at the Jersey Shore recently, hanging with Chris Christie. Did we mention Google, People magazine, Nate Silver, Facebook and.....well, that should help with some SEO.

Britain Royals
Kate Duchess of Cambridge, left, speaks with guests at a Garden Party hosted by Queen Elizabeth II in the grounds of Buckingham Palace, central London Wednesday May 22, 2013. (AP Photo/Toby Melville/Pool)

Anyway, silver (baby) spoon or not, births are births. And sometimes pharmaceutical products are used in the delivery of children. PhillyPharma staff members have been to delivery rooms and heard screams, er, uh, suggestions, that more medication might be considered.

Kate would not be the first woman to have an epidural injection of anesthesia and painkillers while giving birth. In a natural delivery, as Kate's apparently was, the combination is supposed to help with pain, but allow the mother to push the baby into the world.

Since Buckingham Palace might take days or weeks to release the name of the now-third-in-line heir to the British throne, it might be a spell before more details emerge about the 11 hours of labor. PhillyPharma claims no inside sources at Buckingham Palace - staffers stood outside to watch the changing of the guard like the other tourists - but we have other sources and we're grateful to all of them.

One friend of PhillyPharma suggested bupivacaine hydrochloride is one of more commonly used medicines in this situation. Sometimes, it has epinephrine in it.

Marcaine is the brand name for one version, which is made by Hospira, a drugmaker based in Lake Forest, Ill. However, Hospira has had some manufacturing challenges of late. It has a couple dosages of bupivacaine hydrochloride on the U.S. Food and Drug Administration's list of drugs that are currently in short supply. The link to that site is here.

Dr. Richard C. Month, an assistant professor of clinical anesthesiology and critical care in the division of obstetric anesthesia at the University of Pennsylvania, was helpful in providing further explanation of the whole process.

"Most commonly, a mixture of two medications is used in epidurals for labor," Month said in an email. "The first is a local anesthetic, which directly numbs the nerves it comes in contact with (most commonly a medication called bupivacaine - similar to Novocain or lidocaine used at the dentist's office, just longer-acting). Despite being very painful, labor pain is transmitted on nerves that respond very readily to local anesthetic, so very dilute (weak) local anesthetic is able to numb the labor-pain-transmitting nerves without completely numbing the motor nerves (the nerves that supply the muscles).

"The second is an opioid (morphine-type) medication at a very low dose. This helps with certain aspects of the achy pain of labor that is not covered well with local anesthetics. The most common medication used is called fentanyl, but others are used as well. This is effective at such a low dose (locally) that little if any gets into the maternal circulation and no appreciable amount gets into the fetal circulation."

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