There are many different classes of JRA. My Daughter was diagnosed with polyarticular JRA at age 2.5. We did the complete drug regimen starting with the Motrin every 4-6 hours to control it, culminating in Enbrel 50mg injections once a week. There are different drug classes that are usedd to control this in kids. The first step they normally take is just simple anti-inflammatory drugs such as Naprosyn.The second step is called a Disease Modifying Anti-Rhemaitc Drug (DMARD) such as methotrexate. The third step for us was a Biologic Drug that depletes the immune system such as Enbrel, Humira and there is one other I think. When she was on Methotrexate she was unable to have acetaminophen due to the over stressing of the liver (excuse me if I am off a little on this she is now almost 9 and has been in remission for over 3 years). Then when she was on the Naproxen she couldn't have the ibuprofen due to it being processed in the same area of the body. There were certain anti-biotics that she couldn't have at this time either. Bactrum was a big one. I can't remember why though. Enbrel made her really susceptible to Pneumonia and all kinds of infections. As far as dealing wth JRA in the field, I would consult Medical Control to see what they want you do for the pain control part of it. There are a lot of drug interactions that these kids can have depending on what medication they are on to control the JRA. The parents should have a number for the childs rheumatologist so that the doctors can call and confer over what they think needs to be done. My daughters pedi also never hestitated to call the Rheumy to confer about care when they thought it was neccessary. If you have any other questions about JRA feel free to pm me.
Take Care
Em