How do cardioactive steroid lactones exert their effects? It is known that they inhibit Na⊕/K⊕ ATPase, an enzyme that serves in the active transport of Na⊕ and K⊕ across the plasma membrane. To determine where the steroid lactones bind on the enzyme, a flexible synthetic route to compounds of type 1 was developed. The goal was to obtain substances containing a reactive R group. The parent compound 1, R H, inhibits the Na⊕/K⊕ ATPase and exerts a positive inotropic effect.
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