Plasma membrane energy-dependent Na++ pump - Na++ accumulates intracellularly K+ diffuses out of the cell osmotic pull ? cell swelling 2. Cellular energy metabolism is altered increased rate of anaerobic glycolysis - glycogen stores rapidly depleted - lactic acid accumulation ? dec. intracellular pH 3. Failure of the Ca++ pump ? influx of Ca++ 4. Depletion of ATP ? structural disruption of the protein synthetic pathway ? detachment of ribosomes ? reduced protein synthesis 5. Irreversible damage to mitochondrial and lysosomal membranes 6. Proteins may become misfolded ? trigger the “unfolded protein response” that may lead to cell injury or death