Is there any rationale behind the seemingly random silly trade names Big Pharma gives its latest and greatest? One would never guess their drugs' purpose based on their names.

Do people actually get paid to play Scrabble with medicine?

It's changed, like everything else in medicine. Used to be the generic name was denoted the chemical structure, like "acetyl-salicylic-acid" for aspirin (itself originally a brand name, owned by Bayer Farbenindustrie) and hydro-chloro-thiazide, and 1,25-di-hydroxy-Vitamin D (a hybrid). Nowadays there is the classification of generic names is more by function: anything ending in -olol" is a beta-blocker (metoprolol), anything ending with -pril is an ACE inhibitor (enalapril); anything ending in -sartan is an A-2 blocker (losartan); anything ending in -statin is a cholesterol-lowerer (atorvastatin). Never mind what the abbreviations mean, but there is an internal consistency to them.

And newer classifications demand newer names: things ending in -ab (or -mab, or -fab) are made of AntiBody fragments (it's more complex than the mnemonic suggests).

As for the brand names - they are whatever the Focus Groups and marketing department suggested will be most profitable. Those seem to run in cycles. I think (I hope) the current fondness for names beginning or ending in X and Z have run their course. (Ever heard of "Zovirax"?)

Interestingly, in nursing our licensure exam has changed so that they only ask about generic drug names - likely because Canada started taking our exam. At any rate, that means that students mostly learn generic names in school. When I was teaching pharmacology, we'd teach both generic and trade names, and sometimes the chemical names too, to our poor students.

I've always thought it confusing to have 2 and 3 names for drugs. There are so many drugs in the first place, and they are always changing - and then to have so many names. No wonder medication errors are so prevalent.