Which medication should be used cautiously in African American men with moderate persistent asthma?

Salmeterol is a long-acting beta-agonist (LABA) that can have different safety and efficacy profiles based on genetic and ethnic factors. In African American men, there is evidence suggesting a higher risk of asthma-related complications when LABAs are used without an inhaled corticosteroid (ICS). This is due to potential differences in response to these medications among different populations. Specifically, studies indicate that African American patients may experience worsened asthma control when treated with LABAs alone, highlighting the importance of careful prescribing practices in this demographic. Consequently, salmeterol should be used cautiously, and it is often recommended to be prescribed alongside an ICS to mitigate these risks and enhance asthma management.

In contrast, albuterol, montelukast, and fluticasone are typically regarded as safer options for this population. Albuterol is a short-acting beta-agonist useful for quick relief, while montelukast, a leukotriene receptor antagonist, has a favorable safety profile in various populations. Fluticasone, an inhaled corticosteroid, is crucial for achieving and maintaining asthma control and does not carry the same concerns as LABAs in this context. Therefore, due to the potential complications linked to salmeterol in African