Cardiovascular drugs: levosimendan: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular drugs: levosimendan

Sample item

A patient with acute decompensated heart failure and low output is given intravenous levosimendan. Which action underlies its inotropic effect?

AStimulation of cardiac beta-1 receptorsBBinding to troponin C to sensitise the myofilaments to calciumCInhibition of the sodium-potassium ATPaseDInhibition of phosphodiesterase 3 to raise cAMP

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Binding to troponin C to sensitise the myofilaments to calcium

Levosimendan is a calcium sensitiser that binds cardiac troponin C and stabilises its calcium-bound form, increasing contractility without raising intracellular calcium or much oxygen demand. It also opens ATP-sensitive potassium channels, giving vasodilatation. Hypotension and arrhythmias are the main adverse effects.

Option by option

A. Stimulation of cardiac beta-1 receptors
Beta-1 stimulation is the action of dobutamine.
B. Binding to troponin C to sensitise the myofilaments to calcium (correct)
Correct. Levosimendan sensitises troponin C to calcium.
C. Inhibition of the sodium-potassium ATPase
Sodium-potassium ATPase inhibition is the action of digoxin.
D. Inhibition of phosphodiesterase 3 to raise cAMP
PDE3 inhibition is the action of milrinone and inamrinone.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Binding to troponin C to sensitise the myofilaments to calcium. Levosimendan is a calcium sensitiser that binds cardiac troponin C and stabilises its calcium-bound form, increasing contractility without raising intracellular calcium or much oxygen demand.

Why is "Stimulation of cardiac beta-1 receptors" not the answer?

Beta-1 stimulation is the action of dobutamine.

Why is "Inhibition of the sodium-potassium ATPase" not the answer?

Sodium-potassium ATPase inhibition is the action of digoxin.

Why is "Inhibition of phosphodiesterase 3 to raise cAMP" not the answer?

PDE3 inhibition is the action of milrinone and inamrinone.

What concept does this question test?

It tests Cardiovascular drugs: levosimendan in Pharmacology. It also opens ATP-sensitive potassium channels, giving vasodilatation. Hypotension and arrhythmias are the main adverse effects.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular drugs: levosimendan?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.