Intraindividual changes in theophylline clearance during constant aminophylline infusion in children with acute asthma.

Intraindividual changes in theophylline clearance were examined in 13 children with acute exacerbation of asthma receiving a 72-hour constant intravenous infusion of aminophylline. The mean (+/- SD) first, second, and third clearances measured at 24, 48, and 72 hours after the infusion increased from 58.1 +/- 13.8 to 69.7 +/- 28.0 to 84.1 +/- 36.3 ml/hr/kg, respectively (P less than 0.02 from the first and P less than 0.05 from the second). Our results suggest that substantial intraindividual changes in theophylline clearance can occur over a rather short time during intravenously administered aminophylline therapy for acute asthma in children. We recommend that plasma theophylline concentrations be monitored frequently and that aminophylline infusion rate be adjusted on the basis of the measured theophylline concentration data during an acute episode of asthma in the pediatric patient.