Which topical beta blocker on the NBEO matrix is known to have intrinsic sympathomimetic activity (ISA)?

Carteolol is the topical beta blocker known to have intrinsic sympathomimetic activity (ISA). ISA refers to a property of certain beta-blockers that allows them to partially stimulate beta-adrenergic receptors while blocking them, resulting in a more moderate and potentially less deleterious effect on heart rate and contractility compared to non-selective beta-blockers.

Carteolol's partial agonist activity can be beneficial in certain patient populations, as it may reduce the likelihood of side effects like bradycardia and hypotension that are typically associated with full beta-blockade. This unique property differentiates carteolol from the other options listed, which do not possess ISA and tend to have a more pronounced blocking effect on beta receptors without additional stimulation. This makes carteolol a suitable option for patients who may experience adverse effects from non-ISA beta-blockers.