1: A Breath of Fresh Air for Depression?

An RCT of 193 patients found that a single dose of mebufotenin benzoate nasal spray, a 5-HT₁A and 5-HT₂A agonist, showed promising efficacy, safety, and tolerability in individuals with treatment-resistant depression. As a rapid-acting psychedelic, the spray could offer a more convenient option for refractory depression, potentially improving treatment access by requiring a shorter monitoring period than current psilocybin treatments.

2: Less Blood Thinning, Same Protection?

An RCT of 1,857 patients undergoing left atrial appendage closure found that aspirin alone, or 3 months of reduced-dose anticoagulation followed by aspirin, met criteria for noninferiority compared with dual antiplatelet therapy. The study assessed a composite of clinical outcomes over 6 months. The findings suggest that some patients may not need the more intensive antithrombotic regimens traditionally used after the procedure, although treatment decisions still depend on individual bleeding and clotting risks.

Respiratory virus season is in full swing, and every patient interaction presents an opportunity to strengthen vaccine recommendations.

The Power of VAX continues this November with new learning opportunities designed to help Canadian pharmacists build confidence, refine their approach, and navigate the demands of a busy vaccination season.

Each monthly module takes just 15 minutes, with practical strategies you can use during your next shift. Earn up to 2.5 CEUs through CCCEP-accredited learning, strengthen your vaccine recommendations, and discover tools to make those tricky conversations a little easier.

An adult patient comes to the pharmacy looking for help quitting smoking. You're discussing nicotine replacement therapy (NRT), and they ask a reasonable question: if these products contain nicotine too, what makes them different from cigarettes?

The answer goes beyond nicotine itself. It comes down to how it's delivered, how quickly it's absorbed and what else patients are exposed to along the way, including repeated exposure to the smoking cues and ritual that reinforce smoking behaviour.

It's all about absorption

When someone smokes a cigarette, nicotine is absorbed through the lungs and reaches the brain within seconds. That rapid delivery contributes to dependence, while burning tobacco exposes the body to thousands of chemicals associated with smoking-related disease.

Oral NRT works differently. Products such as nicotine gum, lozenges and Health Canada–authorized nicotine pouches deliver nicotine through the lining of the mouth, known as the oral mucosa, rather than through the lungs.

A 2025 systematic review found that, for the 4 mg nicotine pouches studied, blood nicotine concentrations peaked later and at lower levels than with cigarettes. In the pooled analysis of three trials, total nicotine exposure with the 4 mg pouches was estimated at 92% of that with cigarettes (95% CI 85%–98%). The trials measured nicotine delivery.

Why does the format matter?

Not all NRT products deliver nicotine the same way. Patches provide gradual delivery through the skin, while oral formulations offer a different absorption profile. These differences matter when discussing nicotine replacement with patients.

A 2024 review published in Addiction found that NRT remains an effective smoking cessation treatment, particularly when patches are combined with faster-acting formulations such as gum.

There's also a distinction worth emphasizing: unlike cigarettes, authorized oral NRT delivers nicotine without exposing patients to the harmful combustion products associated with smoking.

Bringing the science to the counter

For pharmacists, understanding nicotine absorption can make cessation conversations more useful. Patients may wonder why nicotine replacement is recommended when nicotine itself contributes to dependence, or whether all nicotine products work the same way.

The answer requires some nuance. Nicotine isn't harmless, and different formulations can produce different patterns of exposure. But nicotine replacement and cigarette smoking are not equivalent.

Understanding those differences helps pharmacists explain the role of authorized NRT, address misconceptions about nicotine and support patients working toward smoking cessation.

1: 💊 One of America's biggest pharmacy chains plans to split in two. CVS Health announced plans to split into 2 publicly traded companies, separating its roughly 9,000 retail pharmacies from its insurance and pharmacy benefit management operations. The retail business will become CVS Pharmacy, while CVS Health will retain Aetna and Caremark. Expected to be completed in the first half of 2028, the move marks a major reversal of CVS's strategy to bring pharmacies, insurance and healthcare services under one roof.

2: 💉 Syphilis: an old, treatable disease that refuses to become ancient history. According to a new federal report, infectious syphilis rates more than quadrupled between 2014 and 2023, while congenital syphilis rates more than tripled between 2018 and 2023, with potentially devastating consequences, including stillbirth and infant death. Stigma and barriers to testing and treatment are part of the problem, experts say. They're urging healthcare providers to make sexual-health conversations less judgmental and bring rapid testing directly into communities.

3: 🎉 Some good news for patients with type 2 diabetes. A Canadian-led randomized trial published in The Lancet Regional Health – Americas found that 54% of younger adults with type 2 diabetes achieved remission within 6 months through an intensive, medically supervised diet and exercise program, compared with just 4% receiving usual care. The study followed 96 adults aged 18 to 45, with participants in the intervention group also losing body fat while preserving muscle mass and improving fitness. The next question is whether those remission rates hold up over time.

🍳 Make: Comfort food with a protein boost? This cheesy chicken, spinach and Parmesan spaghetti squash gratin packs 28 grams of protein per serving. A cozy fall dinner without the pasta.

✈️ Travel: Dreaming of a getaway between shifts? Condé Nast Traveler has revealed its 50 best resorts in the world for 2026, as voted by readers. From tropical hideaways to luxurious mountain retreats, consider this your excuse to start planning that next vacation.

💰 Save: Still using an older streaming device? Amazon's Fire TV Stick 4K Max is currently 50% off, bringing the price from $129.99 down to $64.99. Something to consider before your next movie night.

😂 Laugh: If Starbucks ran a pharmacy…

It feels like holiday decorations have been taking over retail stores for months now. And if you're a pharmacist working in one, Mariah Carey's All I Want for Christmas Is You may already be haunting your dreams. But whether you're ready or not, the holidays are coming, and we're curious how you're preparing for the busy weeks ahead.

First clue: ___-care

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your pharmacist friends to beat your time.

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