🏥 USMLE Exam Prep

A patient presents with acute heart failure. Administration of a drug that increases myocardial contractility and decreases heart rate is being considered. Which of the following best describes the cellular mechanism of such a drug on myocardial cells?

A Inhibition of Na+/K+ ATPase, leading to increased intracellular Na+ and subsequent increased Ca2+ via Na+/Ca2+ exchanger.
B Activation of beta-1 adrenergic receptors, increasing cAMP and activating protein kinase A.
C Blocking L-type calcium channels, reducing intracellular Ca2+ influx.
D Increasing potassium efflux, hyperpolarizing the cell membrane.

✓ Correct Answer: Option A

Inhibition of Na+/K+ ATPase by drugs like digoxin increases intracellular Na+, which then reduces the Na+/Ca2+ exchanger's ability to extrude Ca2+. This leads to increased intracellular Ca2+ and stronger myocardial contractions.

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