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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: 4-Aminopyridine, Adult, Chronic Disease, Female, Humans, Male, Middle Aged, Paraplegia, Potassium Channel Blockers, Quadriplegia, Respiratory Function Tests, Respiratory Paralysis, Spinal Cord Injuries.
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Does 4-Aminopyridine improve pulmonary function in quadriplegic humans with longstanding spinal cord injury? Context: To test the hypothesis that 4-aminopyridine (4-AP) might cause clinically evident improvement in pulmonary function in humans with chronic spinal cord injury (chronic SCI). Balanced, open-label study with subjects consecutively enrolled. Spinal Cord Injury Service, university-affiliated tertiary level care Department of Veterans Affairs Medical Center. Seventeen healthy men and women suffering from traumatic SCI (11 quadriplegic, 6 paraplegic patients) for more than 1 year. Each subject was given a single dose of 4-AP 10 mg orally in an immediate-release formulation. Significant increases in mean values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) that persisted for at least 12 hours were demonstrated in quadriplegic patients beginning 6 hours after 4-AP administration. Tests of pulmonary function that demonstrated statistically significant increases at any time were also numerically, if not statistically, increased at 24 hours compared with pretreatment values obtained in 4-AP-naive subjects.
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The administration of a single dose of an immediate-release formulation of 4-AP to humans with longstanding, traumatic quadriplegia is associated with sustained, clinically meaningful, and statistically significant improvements in pulmonary function. We suggest that the administration of 4-AP may have a salutary effect in patients suffering from SCI and appears to be associated with potentially clinically significant reductions in the pathophysiologic pulmonary sequelae of SCI. Final Decision: yes