I'm not even talking about using a random name generator to create entirely new spells and creatures (which is a worthwhile though time consuming pursuit; I just generated the spell name Nassim's Monstrous Drinker, which if I had the time I would write up right here and now). I'm just talking about putting a spin on the tired old standards. I mean, how much more interesting would it be if, instead of discovering a spellbook containing boring old Magic Missile, your mage PC instead found something called Shatter Enemy, Ayz's Silt Flame, or the unbeatable Rage Sadism? The effect changes not a jot - Rage Sadism would be just Magic Missile masquerading under a cooler name - but the feel and flavour is totally different.
Similarly, imagine a campaign in which goblins are not called goblins, but "Obsidian Monkeys", trolls are "Frozen Minotaurs", orcs are "Rash Ghouls" and worgs are "Crystal Howler Locusts". Suddenly the flavour is totally different, and you haven't even had to change a single stat; all you've done is filed off the name and replaced it with another. There is no easier and lazier way of coming up with something different.