• Most commonly from older antipsychotics (esp. Haldol)
• Repetitive, purposeless movements
• Tongue smacking

• Watery eye
• Drooping eyelid
• Runny nose

• Horizontal/rebound nystagmus most associated with drug-induced causes
• Barbituates, phenytoin, sedatives, EtOH, street drugs (hallucinogens)
• Other types of nystagmus mainly associated with brain/nerve lesions, congenital malformations, cancers

• Natural in high-light environments
• Can be drug-induced
• Narcotic analgesics, clonidine overdose, sedative overdose, insecticide overdose, MAO-I overdose
• May result from brain-stem lesions or injury

• UV light
• Smoking
• Diabetes
• Family History
• Prolonged corticosteroid use
• Previous eye surgery or trauma

Xerostomia

• Dry mouth resulting from absent or decreased salivary flow
• Can be drug-induced (affects Muscarinic-3 receptors)
• Other causes:

Uncontrolled diabetes (dehydration)

Sjogren's Syndrome (autoimmune destruction of salivary glands)

Lambert-Eaton Myasthenic Syndrome (impaired release of ACh)

• Leading cause of drug-induced oral pathologies in certain populations
• Leads to severe xerostomia -- vasoconstriction, cutting off blood supply to the mouth
• Has anticholinergic properties

• Mucocutaneous lesions
• Typicaly symmetrical

• White striations or plaques
• Typically on lateral aspect of tongue or on buccal mucosa
• Unilateral lesions much more common in drug reactions than in idiopathic lichen planus
• Presence of eosinophils histologicaly is suggestive of drug reaction
• Should diminish over 5-7 days after discontinuing offending drug therapy

• Co-exists with gingivitis (leading to drug accumulation)
• Chemically-induced overgrowth of epithelial fibroblasts and collagen
• Dose-related incidence
• Phenytoin, cyclosporine, nifedipine

• AKA blood pooling
• Associated with ongoing allergic symptoms