In a cocaine-intoxicated patient with elevated blood pressure and pulse, what complication is most likely to occur?

In a cocaine-intoxicated patient presenting with elevated blood pressure and increased pulse rates, hyperthermia is considered the most likely complication. Cocaine is a powerful central nervous system stimulant that can lead to increased metabolic activity and heightened sympathetic nervous system responses. This overstimulation can cause a significant rise in body temperature.

The release of catecholamines, like norepinephrine, associated with cocaine use contributes to vasoconstriction and increased heart rate, which can further elevate body temperature. Additionally, cocaine can also impair heat dissipation through vasodilation and sweating mechanisms, making the patient prone to hyperthermia.

While the other options listed can occur in various clinical scenarios, they are not directly related to the acute effects of cocaine intoxication in the same way hyperthermia is. Hypercalcaemia, hyperkalaemia, and hyponatraemia can occur under different circumstances or with different substances, but in the context of cocaine use combined with the symptoms of raised blood pressure and pulse, hyperthermia stands out as the primary concern. Therefore, aggressively monitoring for and managing hyperthermia is crucial in this scenario.