Today i have given telma 40 for a 54 yr old patient with bp 180/120

Today i have given telma 40 for a 54 yr old patient with bp 180/120 . On taking history He was not regular in taking medication. I have Checked the bp after 4 hours of giving telma and its still 170/120 . I added amlo 5 mg . Again after 4 hours its still 170/110 . Patient was norml, complaining of only headache . No other complaints . No signs and symptoms of cva , his ecg is norml .
My doubt is how long we should wait for antihypertensives to work ?
Can we take the above readings are norml
. Should i refer the case

Malignant hypertension.

Better refer him to a Cardiologist.

We can try I. V. Nitroglycerin with utmost precautions in ICU setup only

Just waith and watch , blood pressure will fall gradually . There is no need to reduce the blood pressure drastically unless it is hypertensive crisis or emergency.