205COMPREHENSIVE REVIEW AND SURVEY ON OVER-THECOUNTER (OTC) DRUG USAGE IN PHARMACY SHOPS IN TIRUVALLUR DISTRICT, TAMIL NADU: A THREE-MONTH OBSERVATIONAL STUDYOver-the-counter (OTC) drugs are widely used for self-medication, offering convenience and cost-effective management of minor ailments. However, their misuse poses significant public health risks, including adverse drug reactions (ADRs), antimicrobial resistance (AMR), and inappropriate self-diagnosis. This study aimed to assess OTC drug usage patterns, consumer awareness, and pharmacist involvement in Tiruvallur District, Tamil Nadu, through a three-month cross-sectional observational survey. A total of 450 consumers and 50 pharmacists participated, providing insights into OTC drug purchasing behaviors, self-medication practices, and regulatory challenges.Findings revealed that analgesics, antipyretics, and antibiotics were the most commonly purchased OTC drugs, with 26.7% of consumers obtaining antibiotics without prescriptions. Convenience (62.2%) and cost-effectiveness (46.7%) were primary factors influencing OTC drug use, while only 37.8% of respondents were fully aware of potential drug risks. Pharmacist intervention in guiding OTC drug use was limited, with 35.6% of consumers receiving no counseling. Statistical analysis showed a significant association between frequent OTC drug purchases and lower awareness levels (?² = 18.42, p = 0.001). The unregulated sale of antibiotics raises concerns about AMR, highlighting the need for stricter pharmacy regulations and enhanced pharmacist accountability. Public health campaigns promoting responsible self-medication, along with mandatory pharmacist counseling, can mitigate OTC drug misuse. This study underscores the need for regulatory reforms and consumer education initiatives to promote safer OTC drug practices. Future research should explore the long-term health impacts of OTC drug consumption and assess the effectiveness of regulatory interventionspriyanka213111@gmail.comResearch1512025 OTC drugs, self-medication, antimicrobial resistance, pharmacist counseling, drug safety.Dr. Priyanka N1*, Shameeluddin S2, Tamil Anban D2, Gokul N21Assistant professor, Department of Pharmaceutics, GRT Institute of Pharmaceutical Education and Research, Thiruttani, Tamil Nadu, India. 2Students of GRT Institute of Pharmaceutical Education and Research, Thiruttani, Tamil Nadu, India